Covid-19 has influenced the increase in maternal mortality in 2020 and 2021

Maternal mortality refers to the number of women who die during pregnancy, childbirth or within 42 days of termination of pregnancy. It is measured in cups per 10,000 births.

According to data analyzed by Health, in 2018, 68,449 babies were born worldwide and 11 maternal deaths occurred, with a mortality rate of 1.61 deaths per 10,000 newborns, the lowest level in the past 10 years. In 2019, the rate was 2.02, very similar to what was previously reported. But by 2020, the figure rose to 3.44, and in 2021 it rose to 4.05, twice the level in 2019.

The report states that “during 2021, 22 women died during pregnancy, childbirth or postpartum, resulting in a maternal mortality rate of 4.05, that is, the mortality rate in 2021 was twice as high as the 2019 rate of 2.02.” Quote marks.

This was already confirmed in a previous report by the National Statistics and Census Institute (INEC). 40.9% of deaths (9 women) were directly related to complications caused by covid-19.

The Costa Rican Social Security Fund (CCSS) attributed the increase at the time to two main factors: the adjustment of services to prioritize Covid-19 care, as many pregnant women stayed at home and stopped attending prenatal visits.

The number then starts to decline again from 2022 and continues to decline, reaching 1.5 that year and 0.8 in 2023.

For the health aspect, there is an explanation, which is also related to covid-19 or more precisely to the coping strategies.

“Once appropriate health measures are in place and Mandatory application Pregnant women get covid-19 vaccine (As of June 2021)Maternal mortality has dropped significantly, with a total of eight maternal deaths in 2022.”

However, the authors warn that as the number of births decreases each year, the indicator becomes more sensitive and each maternal death is given more weight.

Which women experience maternal mortality?

The Ministry of Health further analyzed four deaths of women since 2023. All were between 35 and 39 years old. Two lived in Limón, one in Puntarenas and the last in San José. The documents show that two deaths occurred in the Huetar Caribe region and two in the Brunca region, which makes it believed that the death in Puntarenas occurred in the southern region and that of Josefina in Pérez Zeledón.

One of them had Metastatic cancer, The other three had bleeding symptoms before, during or immediately after delivery.

“Regarding the causes of death registered, we believe that all deaths are taken into account shock Septic tank typehypovolemia and distributive,” the bulletin states.

he shock Septic shock, or septic shock, occurs when the body overreacts to protect itself from pathogens. Chemicals secreted by the defense system trigger widespread inflammation. This causes blood vessels to clot and leak. As a result, organs are deprived of oxygen and nutrients and become damaged.

he shock Sepsis can also be hypovolemic. This happens when problems occur due to over-contraction of the heart, collapsed veins, and aneurysms in the aorta.

Finally, it can also be distributive: the heart can contract violently, and problems can occur in veins and arteries.

Measures to reduce maternal mortality

The communiqué mentions strategies to reduce maternal mortality, given the increased risk posed by social inequalities and lack of health services.

• Implement policies to improve employment opportunities for women, especially those who are unemployed or underemployed.
• Provide financial support and social protection programmes to ensure all women have access to essential health services.
• Develop specific interventions to support immigrant women, including translation services and culturally sensitive health care practices.
• Ensure legal protection and social inclusion programmes to reduce discrimination and barriers to access care for migrant women.
• Invest in health infrastructure in rural and remote areas.
• Strengthen primary health-care systems to provide comprehensive antenatal and postnatal care.
• Increase funding for maternal and infant health services.
• Train health personnel in respectful maternal care to eliminate obstetric violence.
• Increase awareness and exercise of women’s rights during childbirth.
• Improving the quality of care from a cross-cultural perspective.