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Bangladesh: 8 in 10 women have maternal health problems.


 This article gives an overview of research findings about women's health status during pregnancy and 12 weeks postpartum in three rural areas of Manikganj District, Bangladesh. Findings indicate that in one village 8 out of 10 women had some degree of ill health due to pregnancy or delivery. The study was based on a sample of 2099 women. 97% of deliveries took place at home, and 92% were delivered by a traditional birth attendant. 52% of deliveries were attended by a trained traditional birth attendant, but the rate of infection was unrelated to training. 26% of women showed evidence of infection, such as fever, foul discharge, and lower abdominal pain. 14.7% showed evidence of infection 2-6 weeks after delivery. The likelihood of postpartum infection was related to a longer time in labor. Infection was more likely if hands were inserted into the vaginal opening during the labor and delivery process. Almost 33% of women had one or more serious complications during delivery. 8.4% had labor of over 24 hours. 8.6% had a retained placenta. 7.8% pushed for more than one hour. Common problems after delivery were perineal ones and excess bleeding. 50% of women were anemic to some extent. 10% were severely anemic at 48 hours after delivery and at 2 weeks after delivery. 12.6% of women had a prenatal check-up. Only 1 in 20 women reported use of a contraceptive 3 months after delivery, and many did not have the protection afforded by exclusive breast feeding. Many women held supernatural beliefs about illness. Investigators and international workshop participants recommended promotion of postpartum care, postpartum home visits, breast feeding, and perineal hygiene; provision of antibiotics for treatment of infection and iron for treatment of anemia; and improvement in community awareness about treatment of obstetric emergencies. Services should be directed to comprehensive maternity care, training of TBAs, and adolescent girls.
