American Journal of Health Research
Volume 6, Issue 6, November 2018, Pages: 130-137
Received: Nov. 10, 2018;
Accepted: Nov. 29, 2018;
Published: Dec. 21, 2018
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Dodzo Munyaradzi Kenneth, Centre for Population Studies, University of Zimbabwe, Harare, Zimbabwe
Mhloyi Marvellous, Centre for Population Studies, University of Zimbabwe, Harare, Zimbabwe
Dodzo Memory, Institute of Development Studies, National University of Science and Technology, Bulawayo, Zimbabwe
Maternal death due to haemorrhage is common in developing countries. The clinical and physiological aspects of maternal bleeding are well researched and better known whereas the social, cultural and religious beliefs are not well understood. These cause delays that increase the risk of maternal death. This study sought to close that gap by using qualitative data from twelve (12) focus group discussions with women aged 19 to 49 years and six (6) key informant interviews with traditional and spiritual community birth attendants. These discussions were conducted in five (5) rural districts of Zimbabwe. A grounded-theory approach was used to analyze the data and verbatim quotes are presented with the results. The study found that, among women of child-bearing age, harmful maternal bleeding through the vagina and menstruation are regarded as synonymous. In some cases, harmful maternal bleeding is regarded as a normal and expected feminine experience, a shameful subject for discussion, the body’s self-cleansing process or a necessary occurrence during maternity. In other cases, women fear to raise false alarms. These social constructions of maternal haemorrhage tend to prolong the time between the incidence of bleeding and the instance of receiving appropriate care or death. The researchers conclude that maternal death due to haemorrhage headlines a bigger story involving delays in recognizing danger and deciding to seek care. Interventions must involve women, partners and/or husbands, households and communities to address harmful social norms, beliefs and attitudes towards vaginal bleeding.
Dodzo Munyaradzi Kenneth,
Blood Drain: A Threat to Maternal Health in Zimbabwe, American Journal of Health Research.
Vol. 6, No. 6,
2018, pp. 130-137.
Baskett TF. Complications of the third stage of labour. Essential Management of Obstetrical Emergencies. 3rd ed. Bristol, England: Clinical Press; 1999. 196-201.
Sentilhes L, Vayssière C, Deneux-Tharaux C, et al. Postpartum hemorrhage: guidelines for clinical practice from the French College of Gynecologists and Obstetricians (CNGOF): in collaboration with the French Society of Anesthesiology and Intensive Care (SFAR). European Journal of Obstetrics & Gynecology and Reproductive Biology 2016 March, 198: 12-21.
Central Statistical Office (Zimbabwe) and Macro International Inc. 1995. Zimbabwe Demographic and Health Survey 1994. Calverton, Maryland: Central Statistical Office and Macro International Inc.
Zimbabwe National Statistics Agency and ICF International. 2016. Zimbabwe Demographic and Health Survey 2015: Final Report. Rockville, Maryland, USA: Zimbabwe National Statistics Agency (ZIMSTAT) and ICF International.
Andolina K, Daly S, Roberts N, Tolosa J, Wapner R. Objective measurement of blood loss at delivery: is it more than a guess? American Journal of Obstetrics & Gynecology 1999; 180: S69.
Smith, JR. Postpartum Haemorrhage. Personal Blog. 2018. Department of Obstetrics and Gynecology and Diagnostic Imaging, Credit Valley Hospital, Ontario, Canada.
Sosa CG, Althabe F, Belizán JM, Buekens P. Risk factors for postpartum hemorrhage in vaginal deliveries in a Latin-American population. Obstetrics & Gynecology 2009; 113(6): 1313-9.
Lutomski J, Byrne B, Devane D, Greene R. Increasing trends in atonic postpartum haemorrhage in Ireland: an 11-year population-based cohort study. British Journal of Obstetrics and Gynaecology. 2012 Feb. 119(3): 306-14.
WHO. Factsheet on Maternal Mortality. WHO, Geneva, 2018.
Marshall AL, Durani U, Bartley A, Hagen CE, Ashrani A, Rose C, Go RS, Pruthi RK. The impact of postpartum hemorrhage on hospital length of stay and inpatient mortality: A National Inpatient Sample-based analysis. American Journal of Obstetrics and Gynecology 2017; 217: 344. e1.
World Health Organization. Maternal Mortality in 2000: Estimates Developed by WHO, UNICEF, and UNFPA. 2004. Geneva, World Health Organization
World Health Organization. The World Health Report 2005: Make Every Mother and Child Count. 2005. Geneva, Switzerland, WHO Press
Lancet. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 388 (10053): 1459–1544; 1545–1602. October 2016.
Creanga AA, Syverson C, Seed K, Callaghan WM. Pregnancy-Related Mortality in the United States, 2011-2013. Obstetrics & Gynecology. 2017; 130(2).
Knight M, Nair M, Tuffnell D, Shakespeare J, Kenyon S, Kurinczuk JJ (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care - Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2013–15. Oxford: National Perinatal Epidemiology Unit, University of Oxford 2017. p.iii.
Munjanja SP. Zimbabwe Maternal and Perinatal Mortality Study: 2007. Ministry of Health and Child Care, 2007, Harare, Zimbabwe.
Dodzo MK. Patterns and Determinants of Maternal Mortality in Zimbabwe: 1999 – 2016. Un-published Thesis for a Doctoral Degree in Demography, 2018, University of Zimbabwe, Harare.
Haeri. S. and Dildy G. A. Maternal mortality from hemorrhage. Seminars in Perinatology, 2012 Feb; 36(1): 48-55.
Berg CJ, Atrash HK, Koonin LM, Tucker M. Pregnancy-related mortality in the United States, 1987-1990. Obstetrics & Gynecology 1996 Aug. 88(2): 161-7.
Program for Appropriate Technology in Health (PATH). Postpartum hemorrhage prevention and treatment website. 2011.
Bingham D. and Jones R. Maternal Death from Obstetric Hemorrhage. Journal of Obstetric, Gynecologic & Neonatal Nursing, 2012. July – August, Vol. 41, Issue 14, Pages 531–539
Isah H. S., Fleming A. F., Ujah I. A. O., Ekwempu C. G. Anemia and Iron Status of Pregnant and Non-Pregnant Women in the Guinea Savanna of Nigeria. Annals of Tropical Medicine and Parasitology. 1985; 79(5): 485–93.
Massawe S. N., Urassa E., Lindmark G., Moller B., Nystrom L. Anemia in Pregnancy: A Major Health Problem with Implications for Maternal Health Care. African Journal of Health Sciences. 1996; 3: 126–32.
Van den Broek N. R., Letsky E. A. Etiology of Anemia in Pregnancy in South Malawi. American Journal of Clinical Nutrition. 2000; 72: 247S–56S
New S, Wirth M. Anaemia, pregnancy, and maternal mortality: the problem with globally standardised haemoglobin cut-offs. British Journal of Obstetrics and Genecology: An International Journal of Obstetrics and Gynecology, 2015; 122: 166–169.
Blomberg M. Maternal obesity and risk of postpartum hemorrhage. Obstetrics & Gynecology 2011; 118: 561–8.
Hanley, GE; Smolina, K; Mintzes B; Oberlander TF; Morgan SG. Postpartum Hemorrhage and Use of Serotonin Reuptake Inhibitor Antidepressants in Pregnancy, Obstetrics & Gynecology: March 2016 - Volume 127 - Issue 3 - p 553–561
Haelle T. Venlafaxine Tied to Increased Postpartum Haemorrhage Risk, Medscape Medical News, February 15, 2016; Accessed 18 June 2018.
Hasan R. Baird DD, Herring AH, et al. Association between First-Trimester Vaginal Bleeding and Miscarriage. Obstetrics and Gynecology, 2009 Oct; 114(4): 860–867.
Patel NG, Patel MS, Shah SR et al. Study of outcome of pregnancy in patients with first-trimester bleeding per vaginum. International Journal of Advanced Medicine 2014; 1(3): 230-233
Harville EW, Wilcox AJ, Baird DD, Weinberg CR. Vaginal bleeding in very early pregnancy. Human Reproduction, 2003; 18: 1944–1947.
Thaddeus S, Maine D. Too far to walk: maternal mortality in context. Social Science and Medicine 1994; 38 1091-1110.