Anxious regularity occurs with unexplained deaths of mothers and their babies in the public and private health system in Guyana. The most recent announced are Vanessa Lewis-Sahadeo and Tamera Leslie. Although investigations are almost always launched after some push back to the public, the results of these are not routinely released and even when they are, families rarely get justice which is sought.
One of the standard methods of dealing with maternal and infant deaths is to either blame the individuals themselves or the attending medical practitioner / doctors. Through this single fault method, no sustainable solutions are ever provided for the issue in question. There is also a tendency for medical practitioners to blame maternal deaths and injuries on matters beyond their control such as pre-existing conditions or poor nutrition. They rarely ever explore their own practices and the ways in which they perform in hospitals.
Several measures can be taken to reduce maternal and infant mortality, but key solutions to this include having relevant hospitals in remote communities and a sufficient number of skilled practitioners leading birth efforts. Lack of proper infrastructure increases the risk of maternal mortality. This is evident in the high rates at which native women die during pregnancy and childbirth given that they are less likely to benefit from medical services. With low numbers of skilled personnel such as nurses, midwives and medical doctors, many are overworked and unable to function effectively.
As it relates to midwives, this is an area that requires amped training to build on their skills while also ensuring that women in remote communities have access to relevant care to ensure safe deliveries. The role of the midwife is very important and steeped in local cultural knowledge and traditions. However, decades of over-medicating pregnancy care have resulted in significant midwifery neglect leading to a steadily declining form of maternal care. In Guyana, there have been initiatives to train midwives but there seems to be no very concentrated effort for the area. In Bolivia, for example, there is a government midwifery training program that takes into account the social, economic and cultural constraints on mothers’ access to healthcare. The initiative is rooted in cultural traditions and is extremely important to women living in areas where access to hospitals and doctors is very limited. This program came about after a law was passed recognizing traditional vernacular medicine, including midwifery and led to progressive improvements in infant mortality rates. With Guyana and Haiti being the only two countries with higher maternal mortality than Bolivia in the hemisphere, there are quite a number of lessons that can be learned from initiatives related to maternal and infant care.
However, the barriers to proper access to the health service far outweigh the lack of hospitals or trained medical personnel alone; it also goes towards our social, cultural and economic dynamics such as poverty, geography, racial discrimination, gender inequality and the criminalization of abortion. Statistics show that the birth rate for Amerindia adolescent girls is double that of the general Guyanese population, indicating the danger of lack of resources, cultural norms and persistent attitudes of child abuse, intergenerational poverty and death .
The morbid framing of pregnant women as having “one foot in the grave,” given how often poor and working-class women die regularly while seeking medical help for themselves and unborn children. Especially in developing countries like ours, unplanned and unplanned pregnancies can quickly turn into tragedies as a lack of access to quality health services contributes to that. Increasing efforts to improve healthcare would also have to address the patriarchal practices and policies that fail to prioritize women’s health, nutrition, education, and human rights. We largely continue to avoid our staring at sexual grooming and child marriages that all too often lead to adolescent abuse and pregnancy. Sex education is still stuck in the ineffective age of teaching young people that abstinence is the only way (as if it never works) and women rarely get the medical treatment they need leading to ongoing overflow of death and health complications.
Maternal and infant mortality is what can be called recoverable injustice. It is a condition that is not only completely unfair but also within our capacity for change. Although efforts to reduce death rates have seen some positive results, there is still much work to be done to significantly reduce the rate at which mothers and their babies die under the care of medical personnel. What continues to be revealed are the systemic failures that exist and the disregard that women, families and their communities face when tragedy strikes.