Role of diet in reducing maternal mortality
In the fast growing and advancing world we live today, one is quick to associate death of mothers during child birth with deliveries outside hospitals and clinics or accredited delivery centres. It is however sad to observe that this phenomenon is not wholly true.
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Maternal deaths during pregnancy and delivery nowadays have no respect for hospital or home. Deliveries at the hospital record highest levels of survival among mothers anyway.
The same facilities also record unacceptable levels of deaths among women who deliver through them.
What could be the cause? Can we as a nation just pause and think of what the cause could be?
Maternal health is complex and influenced by various factors. These are genetic, social and economic factors. Infections and environmental conditions cannot be ruled out.
In every serious health care system, various approaches are needed to ensure that mothers go through pregnancy and deliver safely.
Before pregnancy, one should be adequately prepared. Physiologically, the woman should attain such an age that will enable safe conception and delivery. Psychologically, she needs to be up to the task.
Economic development cannot be over looked. The mother or couple must be able to pay for the care during pregnancy, delivery and care of the infant. In addition, a woman needs to be nutritionally prepared before conception. Thus she needs to be in a good nutritional status.
This article throws more light on nutritional preparations needed before, during and after pregnancy.
Before pregnancy
Women with low body weight and poor nutritional status prior to pregnancy have more low birth weight infants, premature spontaneous rupture of membranes, infections and anaemia.
These developments impinge not only negatively on the infant but also on the mother.
On the other side, overweight women are more likely to have foetal deaths, diabetes, hypertensive disorders and labour abnormalities. These are top among the causes of maternal mortality in Ghana.
In diabetics, the incidence of congenital defects can be reduced by bringing the blood glucose under good control prior to pregnancy.
The rule of thumb should be that women going into pregnancy should have a normal body mass index. Pregnancy weight gain should be adjusted appropriately for women with low and high body mass indices prior to pregnancy.
Having a balanced meal is the surest way to ensure an adequate weight, an excellent store of energy and nutrients for the demands of pregnancy and to ensure the production of sufficient milk to nourish the new born baby.
Folic acid must be adequately present in the diet of any woman who intends to become pregnant. These foods are rich in folic acid; leafy green vegetables, asparagus, citrus fruits, fortified cereals, beans, peas, peanuts, and whole grains.
During pregnancy
Blood volume expands to allow the circulation of blood through the placenta. This also allows the blood to carry nutrients and oxygen to the foetus and metabolic wastes away from the foetus.
Increased blood volume produces a high glomerular filtration rate. The renal tubules are unable to adjust completely so a percentage of nutrients are excreted in the urine.
Increased amounts of amino acids, glucose and water soluble vitamins may appear in the urine. This may account for the increased number of urinary tract infections seen in pregnant women.
There are other physiological changes that occur during pregnancy i.e. decrease in haemoglobin status, increased white blood cells, reduced serum albumin, decreased serum vitamin C, folic acid and vitamin B12 among others.
Some of these changes require slight increases in energy and some nutrients so as to ensure a favourable pregnancy outcome.
To be continued
• The writer is a dietician at the Trust Hospital and author of "Eating to prevent and manage lifestyle diseases" and “Answers for your diet”.
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