Hemorrhage is the leading cause of maternal mortality

Some mothers often experience hemorrhage during childbirth, and at times, it becomes necessary to administer blood transfusions. In some cases, the bleeding is so severe that it leads to life-threatening complications.

In testimonies shared by parents interviewed by mamedecine.com, they described their experiences, explaining what happened to them and offering reasons for what they believed caused the hemorrhage.

One of the mothers, referred to as MUNDERERE, said: “I gave birth and then started feeling weak and losing consciousness. When I regained my senses, I found myself in terrible condition with blood transfusions. I was in a very bad state, on the verge of dying.”

Another mother, named Melanie, shared her experience of losing her daughter during childbirth. She was dissatisfied with the explanations the doctor gave her regarding the cause of her child’s death.

She said: “I think my child was cursed. How could everything have gone well during the pregnancy, only for my baby to die shortly after birth?”

After speaking with these mothers, the journalist from mamedecine.com reached out to Dr. NDIKURYAYO Emmanuel, a gynecologist at MBC-Kigali Hospital, who provided a detailed explanation about hemorrhage during childbirth and offered advice on how to manage it.

Dr. NDIKURYAYO explained: “This issue should not be attributed to witchcraft, as it is one of the common complications women face after childbirth. It is the leading cause of maternal death globally.”

He continued: “Normally, the uterus without a baby is small, about the size of something you can hold in your hand. Now, when a baby weighing 3 or 4 kilograms, or even more, along with the amniotic fluid, is inside, there are blood vessels connecting the uterus to the placenta, which supplies blood to the baby. Once the baby is born, the placenta follows, and the blood vessels break. It’s like water flowing.”

He added: “The reason the bleeding stops is that the uterus should contract and become hard, almost like a stone. This action seals the blood vessels that were carrying blood to the placenta, halting the bleeding. Sometimes, the uterus does not contract or harden enough to stop the bleeding. This is why, after childbirth, midwives often massage the new mother’s belly to help the uterus harden. If it turns into a stone-like state, the bleeding stops. But if the uterus is unable to contract, the bleeding continues, which can lead to the mother losing too much blood and potentially dying.”

 Who is at risk of hemorrhage during childbirth?

Dr. NDIKURYAYO further explained that some women are at higher risk of experiencing hemorrhage during childbirth due to specific conditions.

He said: “Although all women may bleed, some are more at risk. These include women with an over-distended uterus, which happens when they carry large babies (over 4 kilograms), have twins or triplets, or even more, a condition known as multiple gestation. Others are those who have excessive amniotic fluid, which also stretches the uterus. All of these women are more likely to experience Hemorrhage.”

He continued: “Women who have had multiple pregnancies are also at risk because the uterus becomes weaker. The uterus can be compared to elastic material that stretches and loses its ability to contract after repeated use. After five or more births, it becomes more difficult for the uterus to contract properly, increasing the risk of excessive bleeding.”

Other factors that can weaken the uterus

Dr. NDIKURYAYO also mentioned that prolonged labor contractions can weaken the uterus. If a woman has difficulty going into labor and requires medication to stimulate contractions, it can strain the uterus and increase the risk of bleeding. Additionally, infections can also weaken the uterus, leading to hemorrhage.

He also warned against the use of traditional medicines applied to the abdomen, saying: “Sometimes a mother may apply herbs or leaves to her belly, which can cause the uterus to contract too much, leading to complications that can result in hemorrhage or even harm the baby.”

Reason why every woman should give birth in a medical facility

Dr. NDIKURYAYO emphasized that every woman should give birth in a healthcare facility. He explained: “We encourage everyone to give birth in a medical setting because there are planned interventions to help the uterus regain the ability to contract after delivery.”

He added: “One of the interventions is the administration of oxytocin after childbirth to help the uterus contract. We also provide abdominal massage to help strengthen the uterus. Additionally, we prevent the uterus from becoming too relaxed by actively managing the delivery.”

Research findings on maternal mortality

A study conducted by the National Institute of Statistics of Rwanda (NISR) on health and living conditions in 2014/2015 revealed that 210 mothers died due to childbirth complications. By 2019/2020, the number of maternal deaths had decreased to 203.

By Fulgencie MUKAMUSONI