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Death by Delays to Mothers (the 4 Ds)

"Major causes of maternal mortality should include infra-structural and cultural factors. From public health perspective, the major causes of maternal mortality can be stated in terms of the 4.Delays (4Ds): delays in deciding to seek health care, transporting client to health facility, delays in reception at the health facility and delays in instituting treatment needed at the hospital. From a clinician /physician point of view (which is based on aetiology) the five most common causes are: hemorrhaging(bleeding) before or after delivery of the baby; sepsis(usually during or after delivery; Eclampsia (seizures associated with increased blood pressure before, during or after delivery); Prolonged and obstructed labor (especially where trained health personnel are not available); and Unsafe abortions(termination of pregnancies before 20 weeks in unclean settings by untrained personnel) An estimated 74 per cent of maternal deaths are preventable."


"...traditional birth attendants are being trained to take deliveries safely (clean deliveries) and also to be able to detect what we call “danger signals,” which must prompt timely transfer of a women to the nearest health facility.

"In the long run, something must be done to effectively combat maternal mortality in the region.

"Simply put, the issues that need to be addressed in the long term are women empowerment, better health care systems, reduction in poverty rates, provision of water, improvements in sanitation, and elimination of harmful cultural practices such as child marriage, and female genital mutilation."

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Searchlight Centre for Democracy and Development, June 2010, pg 12: