Without Prenatal Care, Pregnancy Presents Fatal Problems

Just 14 days after her wedding in February, Mop Mom received some welcome news: She’s having a baby girl.

“Even before the wedding, my husband and I really wanted a ba­by,” Mop Mom said, rubbing her belly and smiling. “When the news came, the whole family was excited, especially my mom. She cried.”

Now seven months pregnant, Mop Mom, 23, has added 12 kg to her initial weight of 48 kg. She has also earned added respect from family and friends and a newfound confidence, she said.

“Experiencing pregnancy, a wo­man’s body and mind changes,” said Mop Mom, a self-employed hairdresser and makeup artist in Phnom Penh.

For many middle-class women in Phnom Penh like Mop Mom, pregnancy can be a joy, but for the majority of Cambodian wo­men living in the countryside, it is often considered a burden and sometimes dangerous, re­pro­ductive health experts say.

“Pregnant women in rural areas lack food, and good nutrition can prevent maternal mortality deaths,” said Chan Theary, executive director of Reproduc­tive and Child Health Alliance, one of the largest local NGOs dealing with maternal and child health.

“Many Cambodian women are already anemic before they be­come pregnant and, during pregnancy, they lose more iron as they pass it to the developing fetus,” she said.

According to a 2000 Cambodia Demo­graphic and Health Survey by the Ministry of Health, 58 percent of women between the ages of 15 and 49 are anemic, having a blood condition that generally causes weakness and fatigue. And about 21 percent of women are under weight.

“When they are underweight and become pregnant, it is very dangerous and can cause a high risk of hemorrhaging, still births, and a low birth weight baby,” said Dr Tung Rathavy, the national program manager for reproductive health at the Ministry of Health.

Internal bleeding during pregnancy or delivery, is the leading cause of maternal mortality, second to pre-eclampsia, or high blood pressure which can be caused by poor nutrition and hormonal changes, Tung Rathavy said.

Without medicine, pre-eclampsia leads to convulsions, she said.

Infection is also a common cause of death, she added.

To boost their iron intake, ex­pectant mothers should eat plenty of leafy green vegetables like morning glory and yellow fruits, such as mango, doctors say.

Some 66 percent of Cambo­dian women still rely on traditional “birth attendants”—usually an elderly woman in the village—to deliver their babies at home, Tung Rathavy said.

These birth attendants usually do not have adequate medical training and can be ill-prepared to deal with some of the complications that can occur during childbirth, she said

“They learn by person to person. This can be considered to be dangerous because there is no proper training,” she said.

If an untrained birth attendant cuts a ba­by’s umbilical cord with un­clean instruments, for example, both for the child and the mother can be at risk of fatal infections, she said.

A lack of transportation, access to public hospitals and money often force women to opt for home deliveries by traditional birth attendants, Chan Theary said.

The $10 to $12 it costs to have a baby delivered at private clinics is often too much for expectant mo­thers to afford, and transportation to clinics can run the cost, depending on the distance, she said.

Health experts said they often have to counsel expectant mothers against misinformation stemming from Khmer superstitions.

Mop Mom heard that pregnant women should not stand in front or near an open door be­cause standing in such an open space can bring bad luck and spirits to the child. Also, pregnant women should not take showers late at night. And afternoon naps are a “no-no”— a point of disagreement with her doctor.

Physicians say they recommend that pregnant women should definitely take afternoon naps, and make regular visits to a doctor to check for high blood pressure and birth defects.

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