1. Each year, nearly 200,000 women die after delivery
The World Health Organisation reported in 2014 that, worldwide, an estimated 289,000 women die from “complications related to pregnancy, childbirth or the postnatal period.” Two-thirds of these (almost 200,000) occur after the baby has been delivered. Because of this, or in spite of this, WHO states that: “Compared with other maternal and infant health services, coverage for postnatal care tends to be relatively poor.”
The disparity between high- and low-income countries on this front is striking. WHO estimates that in high-income countries the risk of death is one in 3,400, while in low-income countries it's one in 52. In 2013, the organisation found that 99% of maternal deaths occurred in developing countries. The sub-Saharan Africa region accounts for 62% of this figure, where the leading cause of maternal death is postpartum haemorrhage.
2. In the Democratic Republic of the Congo, only 35% of women receive postnatal care
While in Kenya, fewer than 20% of women use postnatal care services. WHO identifies the contributing issues as being “[a] lack of education, poverty and limited access to health care facilities.” Women who had access to secondary education were found to be more likely to use postnatal care, as were those who were more financially stable, and those who lived in urban areas.
3. In low-income countries, 15% of women develop potentially life-threatening problems after birth
WHO found that in 2015: “births in the richest 20 per cent of households were more than twice as likely to be attended by skilled health personnel as those in the poorest 20 per cent of households.” Millions of women have no medical assistance as they give birth, leading to long-term health complications. Postnatal care is, at this point, crucial – but few women in low-income countries are able to access it, often with fatal results.
Lack of education, financial stability and access to health centres aren't the only issues faced by women in low-income countries. These areas have often been subject to conflict, political unrest and natural disaster.
4. In 2012, birth trauma was the seventh largest killer in Afghanistan
Among the top ten causes of death in Afghanistan, birth trauma kills more people than both tuberculosis and road injuries. It has widely been reported how unsafe the country is for pregnant women, and maternal deaths may be worse than current figures suggest.
5. In the US, routine postnatal care usually consists of just one visit with a doctor
WHO recommends that a woman not only receives postnatal care within the first 24 hours of birth, but also that she has three more visits with a doctor or midwife. And yet in the US, women routinely have just one medical visit six weeks after birth.
Alison Stuebe, a researcher on the Fourth Trimester Project, says that: “The baby is vulnerable and precious and has resources devoted to it, and American culture doesn’t appreciate that the mother is recovering from a process.” Her colleague, Kristin Tully, pointed out one negative consequence of this. “Women don't know the range of what’s normal, when to seek guidance, and whom to ask."
Women in the UK also receive just one postnatal check, and not all GP surgeries offer it routinely.
6. In the UK, a third of mothers feel they're discharged from hospital too soon
In 2014, the Royal College of Midwives discovered that 40% of women were discharged from hospital before they were ready to leave. This survey also found that only a third of midwives felt they had enough time to review postnatal care plans. In addition, many women report being passed onto health visitors after just three midwife visits – a cause for concern, given that they don't have the same level of training in maternal healthcare.
“The continuing shortage of midwives particularly in postnatal care […] means that organisational needs are preventing midwives giving care based on clinical need," Cathy Warwick, chief execute of the Royal College of Midwives, said. “Women are not getting the best possible postnatal care. This can have a massive impact on the health and wellbeing of the mother and her baby after the birth and well into the future.”
She went on: ”We are seeing women being discharged earlier without adequate support. This leads to readmissions and more cost to the NHS. It is a false economy.”