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May 7, 2011

Closely spaced pregnancies put maternal, newborn lives at risk


May 7, 2011

Getting pregnant soon after childbearing, miscarriage or abortion places mothers and newborns at a higher risk of health complications or even death, said Dr. Ali Muhammad Mir, chief of party of the USAID-funded Family Advancement for Life and Health (Falah) project, on Friday.
“Unhealthy pregnancy spacing is associated with multiple adverse outcomes for mothers and newborns and that included even death. In case of early pregnancy when mother is younger than 18, she and her newborn faces the increased risks of multiple adverse outcomes compared with one aged between 20 and 24,” Dr. Mir told this scribe.
The Falah chief said the research showed that pregnancy occurring within six months of a live birth increased the risk of induced abortion by 650 per cent, miscarriage by 230 per cent, death of newborn below nine months 170 per cent, maternal death by 150 per cent, pre-term birth by 70 per cent, still birth by 60 per cent and low birth weight by 60 per cent.
He said World Health Organisation recommended an interval of 24 months from a live birth to attempting the next pregnancy in order to reduce the risk of adverse maternal, prenatal and infant outcomes.
Referring to the findings of the last Pakistan Demographic and Health Survey, Dr. Mir said in Pakistan, neonatal mortality was almost double for babies born to teenage mothers compared with those born to mothers aged 20 or above, adding avoidance of such births could significantly reduce neonatal and post-neonatal mortality.
He also said neonatal mortality for babies born with less than 24 months of the preceding birth interval had almost two times higher than the babies born with more than 24 months of birth interval.
“If all births occur with over 24 months of birth intervals, then neonatal and infant mortality can be reduced by one third,” he said. The Falah chief said more than 850 maternal deaths per every 100,000 live births for mothers, aged 40 or above and 637

maternal deaths for mothers between 35 and 39 years of age were reported in the country. He said if pregnancies to mothers over 35 years of age were avoided, then maternal mortality rate would considerably drop.
Dr. Mir said under Falah project being implemented by a Population Council-led consortium, efforts were being made to protect health and well being of mothers, newborns and children in the country through adoption of birth spacing by eligible couples in 15 districts of all four provinces.
“Our goal is to bring about an increase in adoption of birth spacing behaviour and practice of WHO recommended birth spacing interval under the guidelines of ‘Healthy Timing and Spacing of Pregnancies’ for marked improvements in maternal and child health and decline in their mortality rates due to pregnancy related complications.
“And we’re trying to achieve that goal by removing barriers, improving people’s understanding of the benefits of birth spacing, increasing their awareness of the risks associated with early, late, closely spaced and high parity pregnancies, increasing public knowledge of various contraceptive options available, and improving access to and quality of care in both public and private sectors,” he said.
The Falah chief said to strengthen quality of services, the Population Council and JHPIEGO, an international health organisation, in collaboration with the Population Welfare departments were reviewing and strengthening the family planning curriculum for medical students, nurses, midwives and paramedics.
He said the Population Welfare Ministry updated the Manual of National Standards of Family Planning Services in collaboration with TAMA on the inputs provided by the project, adding the revised manual is being disseminated to public and private health sector family planning organisations.
Dr. Mir said Falah was supporting and facilitating introduction of new family planning methods such as Lactational Amenorrhoea Method and Standard Days Method through the relevant government departments.
He said Falah was also engaged in creating demand and ensuring a wide scale supply and distribution of contraceptive commodities through social marketing programmes and selective commercial private sector partners.
“This is based on the total market approach where market is encouraged to grow in sustainable ways reducing dependency on the public sector and the donors to pay for the increasing commodity requirement of a growing market,” he said.

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