By Dr. Farah Akram.
(Follow-up on stop the stunting.)
I already discussed the statistics revolving around stunting in my last article. I also outlined some of the main reasons, but I feel the need to go into greater detail as people still might not grasp where the errors are being made. It is a complicated issue with too many determinants, however, I am sure where resolve is strong, the right answers are soon found.
So, maternal support, I think a lot of people don’t even have the concept of what that is. Well, maternal support means helping a woman to meet the optimal standards of health before, during and after pregnancy. We need to ensure that women are ready for motherhood rather than being forced into it due to pressure form the partner or society. And once pregnant, we need to ensure she has access to proper antenatal care, health assessments and whatever supplements that are required. Now this isn’t possible if a lady doesn’t have the support of her partner, her family and the healthcare providers. BUT it takes one person to change the situation for the better so please speak up – for yourself, your partner or your patient.
The usual supplements prescribed are iron and folic acid AND many women fail to take these. Taking pills can be annoying, I know I’ve skipped them sometimes too but this is important, not just for mother’s health but the baby’s as well. Other than the lack of will, there are other reasons why supplements are not being taken – financial burden makes supplements an unnecessary expense rather than an investment in health (of 2 lives!!). Also, I don’t think people have an idea of what adverse effects can occur by NOT taking the pills. Hopefully this article can educate the community and raise awareness so that such information is common and widespread, hopefully having a positive impact on the health of many.
Low iron stores can lead to maternal anemia, presently ranging from 35-75% prevalence in Pakistan. This is associated with greater risk of infection, high incidence of haemorrhage, maternal fatigue, all culminating in greater risk of maternal death – about 190 maternal deaths per 100000 live births. Maternal anemia has negative implications for the baby too – preterm birth, low birth weight, lower APGAR scores, greater risk of asphyxia, low stores of iron and other nutrients, and growth-stunting.
Low levels of folic acid also leads to some undesired effects. Folic acid is needed for the production of red blood cells; therefore its deficiency also contributes to maternal anemia. This then can lead to low birthweight and preterm labour. One major impact of folic acid supplements is to prevent Neural Tube Defects, like spina bifida and other congenital anomalies like cleft lip/cleft palate, etc. In fact folic acid is recommended if a woman is simply planning a pregnancy.
Other than this, ideal antenatal care of a mother monitors her glucose levels and blood pressure. Is there any significance? Research is now identifying link between pre-diabetic pregnant women followed by low milk supply postpartum. With diabetes and prediabetes on the rise, we are looking at increased prevalence of mothers with low milk supply.
Problems with high blood pressure are pretty well-known. For those who are not aware, high blood pressure during pregnancy can lead to eclampsia – a possibly fatal medical emergency where a pregnant woman gets seizures from high blood pressure, eventually leading to emergency delivery of the baby. It is a condition that endangers both mother and baby but it can be prevented by educating families and monitoring blood pressure closely during pregnancy.
Good antenatal care helps to take care of minor problems before they become life-threatening medical emergencies. Short-term antenatal care can help so much in the long-term by ensuring a healthy pregnancy ends with a healthy mother and baby. Supplements, blood sugar and blood pressure tests are relatively simpler, cheaper and more readily available than the medical care required, if God forbid, any of the adverse effects mentioned above occurs.
We have all heard the phrase “healthy mother = healthy baby.” Truly, healthy mothers nourish and nurture and not just lead to healthy babies but actually contribute to a healthy nation.
Dr Farah Akram. May Allah guide us to all that is good and right. Ameen.