HONDURAS-HEALTH: Maternal Mortality Rate – a Pressing Challenge

By Thelma Mejía Reprint | | Print |

Thelma Mejia

TEGUCIGALPA, May 27 1996 (IPS) - One of the most pressing health problems in Honduras is maternal mortality, pushed up by a high incidence of teen and over-35 pregnancies, too-close spacing of births, high levels of malnutrition and illegal abortions.

Health ministry reports indicate that the maternal mortality rate is 221 per 100,000 live births — compared to 12 per 100,000 in Germany, 36 in Uruguay and five in Spain, for example — one of the highest in Latin America.

Some 2,600 women a year die from problems related to pregnancy, birth and post-partum complications in Honduras.

Maternal mortality is highest in rural areas, where women are at greater risk of giving birth prematurely.

In those areas — according to a study by the office of planning and budget (SECPLAN) — women frequently get pregnant when they are 13 to 15 years old, thus increasing their risk of dying in childbirth.

The number of children is also a factor influencing the maternal mortality rate. The average number of children in Honduran families is seven in rural areas and four in urban settings.

A generalised lack of knowledge regarding pregnancy and child- birth also contributes to maternal mortality.

According to Leonel Perez, a physician with the Department of Obstetrics at the state-run Hospital School, a majority of maternal deaths occur among “child-mothers”, who are prone to problems such as hemorrhaging during pregnancy and birth, post- partum infections and hypertensive disorders.

To that is added the problem of abortions, which “is becoming more and more serious in this country because of the illegality of abortions, and the consequences for women who practice them without any knowledge whatsoever,” Perez said.

It is estimated that nine percent of all abortions end in the pregnant woman’s death.

SECPLAN reported that 67 percent of maternal deaths occur at home, and 33 percent in hospitals and other health centres.

The goal of the health ministry is to cut the maternal mortality rate in half by the year 2000, through intensive educational campaigns geared towards teenagers and women over 35.

Nearly one third of the more than 180,000 births registered yearly in this country are considered high risk. Teenagers account for 16 percent of all births, and over-35-year-olds for 15 percent.

Another factor that makes pregnancies high risk is malnutrition, which plagues seven of every 10 Hondurans, while women are the most vulnerable group, the health ministry reported.

Karla Lezama, a health educator working with the government, told IPS that the country’s maternal mortality situation “is so serious that it can be compared to the economic crisis we are experiencing.

“The difference is that maternal mortality is not a priority for government technocrats. And for that reason, hundreds of women in this country die unaware that a simple injection or vaccination could have saved them,” she stressed.

Lezama said the area of education is suffering a similar crisis. A majority of Honduran women are illiterate. And they resist any family planning methods due to opposition by their husbands, and because “they consider it an offense against God.”

According to studies carried out by the health ministry, rural women tend to have children at 18-month intervals, an extremely short period that weakens womens’ bodies and puts them at higher risk of dying during pregnancy or childbirth.

Perez, at the Hospital School, said such close spacing not only brings problems for the mothers but for their children as well, many of whom fail to reach their second birthday due to low weight or malnutrition.

The major offensive to be launched by health authorities late this year is designed to combat teenage pregnancy, cut pregnancy and childbirth-related deaths and step up controls on abortions.

“With this plan, we are not seeking to control the birth rate 100 percent, but rather…to avoid low-birth weight, malnutrition and other problems that destroy the lives of children and their mothers” — in an effort to ensure the country’s future which is based on its children, Perez emphasised.