When mothers die

Daan blogs from Haiti, where he and the team provide the most advanced emergency care for pregnant women in the country. He blogs about the fight to save mothers' lives, and the obstacles that mean this isn't always possible...

A woman arrives at the MSF maternity hospital in Port-au-Prince, Haiti

Because of advanced care and good infection control we can save most babies in our emergency obstetric hospital. Sadly we lose some newborns every month, but that's to be expected, as we admit a lot of very small and premature babies. Even if it's hard, it's still normal, because very often they were just not ready to live.

What is a tragedy, however, is every time we lose a pregnant woman. It's rare in our hospital, but it still happens once or twice every month. These dramas are unfortunately not a big surprise, since the maternal mortality is as high as 350 per 100,000 in Haiti. Even if we manage the most advanced emergency obstetric centre in the country, we cannot avoid every death in this setting. 
45% of women in the world don't have access to antenatal care
The reason why some women still die in our hospital is because they often arrive when they already are in a very bad condition. The combination of poor education and a lack of proper medical care close to where they live, is a recipe for disaster.
A shortage of the right medicines or blood in nearby health centres are two reasons why women worldwide still die around childbirth. Delay in care is also an important factor. 45% of women in the world lack antenatal care, which means that emergencies are not detected in time. 

It still gives me cold shivers and makes me angry every time

But the underlying reasons are poverty (no money for a doctor or transport to hospital), lack of education and gender inequality.
Seeing premature babies die remains hard, even as a paediatrician. But what still gives me cold shivers and makes me angry every time, is when I see a stretcher passing by, covered by a blanket, the shapes of a human body clearly visible under it. 
Every time it is someone's wife, someone's sister, someone's daughter.
A woman arrives at the hospital by ambulance

A patient arrives by ambulance at MSF’s Centre de Référence en Urgence Obstétricale (CRUO) in Port-au-Prince, Haiti. Photo: Shiho Fukada / MSF