What are the danger signs in pregnancy and after childbirth?

HEALTH & LIVING: Maternal mortality rate is still a global issue despite the various efforts by most countries to reduce it.  Although a decrease in the number of deaths began to be measured, the progress was too slow to meet the Sustainable Development Goals (SDG) target of 2030.
Approximately 810 women die every day from preventable pregnancy-related causes and childbirth. According to the World Health Organisation (WHO), over 94% of these maternal mortality events are mainly concentrated in low-income countries like Uganda and are related primarily to the lack of access to essential health services. 

According to the 2019 WHO report, globally the maternal mortality rate was 216 per 100,000 live births, while for Uganda, maternal mortality reduced from 418 per 100,000 live births in 2006 to 336/100,000 in 2016 according to the Uganda Demographic and Health Survey. 

Maternal deaths are caused by multiple factors and the direct causes of maternal death include complications during pregnancy, childbirth and postpartum. Most of these complications develop during pregnancy, but others may exist before pregnancy and become worse during pregnancy.
Major complications of severe bleeding (mostly bleeding after childbirth), infections (usually after childbirth), high blood pressure during pregnancy (pre-eclampsia and eclampsia), complications from delivery like obstructed labour and unsafe abortions account for nearly 75% of all maternal deaths globally. The remainder are indirectly caused by or associated with infections such as malaria or related to chronic conditions like cardiac diseases or diabetes.

However, in general, the complications during pregnancy and the possibility of risk during childbirth can be detected early through proper assessment of risk factors or danger signals during pregnancy. In short, if the mother understands the danger signs during her pregnancy period, then deterioration can be avoided.
Unfortunately, we still have many mothers who are less aware of the danger signs in pregnancy and they indicate the presence of a condition that increases the risk of a pregnant woman or her unborn baby dying or predisposing them to poor health. 

Maternal danger signs in pregnancy and after delivery include; vaginal bleeding during pregnancy, convulsions/fits, severe headaches with blurred vision, fever and the mother is too weak to get out of bed by herself, severe abdominal pain, fast or difficult breathing, severe abdominal pain, swelling of fingers, face and legs, severe vaginal bleeding after delivery, foul-smelling vaginal discharge after delivery and many others. It is therefore important that women and their families are able to recognize these danger signs accurately and act appropriately with no delays.
It is very important to make a fast and quick decision to seek for appropriate health attention immediately, mobilize transportation as fast as possible in-case one lives far away from the hospital. If such quick interventions are done, this will increase the safety of the mother’s pregnancy and childbirth-related issues.

We therefore recommend all pregnant women, their families and the entire community to be aware and conscious about the maternal danger signs in pregnancy and after child birth. Let us not ignore the simplest danger signs of all and avoid self-medication. Most importantly, let us quickly make decisions and take women with such danger signs to the nearest health facilities for proper management.

The authors are; Godfrey Oyaro, a volunteer working with Lugazi School of Nursing and Midwifery and 
Lilian Nuwabaine Luyima, BSc Nurse & MSN-Midwife and Women’s Health Specialist working with Aga Khan University as the Continuous Professional Development Coordinator