There is a rural area in Mpumalanga Province, South Africa where the maternal mortality rate more than doubled from 2011 to 2012. Why are women so at risk for dying during childbirth in this province? The reasons are complex and inter-related but many factors can be addressed by the provincial Minister of Health. And we are demanding that he does.
Many issues revolve around access to care. Rural clinics are hard to reach because of infrastructure challenges and cost of transport, ambulance service is insufficient, and once expectant mothers reach a clinic, privacy concerns stop many women from returning. HIV positive patients are frequently easily identified by the way they are treated by health care workers.
South Africa remains a fairly traditional society and teen mothers report they are often treated badly and stigmatized when they seek health care. These issues discourage mothers from seeking appropriate prenatal care that could treat and identify many of the risk factors that lead to maternal death.
There are other, more intractable issues that contribute to the maternal mortality crisis including high rates of gender-based violence and male partner refusal to wear condoms. However, sensitivity and patient privacy training for health care workers, reproductive rights education, and increased physical access to clinics for pregnant women are attainable solutions that will make a real difference.