By The Insight Post Uganda
Mukono-Uganda
The prevailing wave of Stillbirth in Mukono district has brought to the forefront the pressing need to address the gaps in maternal healthcare in the district. Stillbirth, defined as the unfortunate occurrence of fetal death at or after 20 or 28 weeks of pregnancy, has emerged as a significant concern, casting a shadow on the region’s healthcare system.
This devastating loss not only affects the immediate families but also highlights the critical importance of enhancing healthcare infrastructure to prevent stillbirths in the district and the entire greater Mukono region.
Stillbirth is the tragic event of fetal death that occurs at or after 20 or 28 weeks of pregnancy. It is simply the loss of a baby before birth, and the baby is born without any signs of life.
According to Geoffrey Kasirye, the Medical Superintendent of Mukono General Hospital, the legislators were informed that the facility records an average of 20 new stillbirth cases each month.
The facility sees over 900 deliveries every month, with approximately 250 of them being cesarean sections, as per the hospital’s records. Out of these deliveries, only about four mothers lose their lives each year due to postpartum hemorrhage (PPH).
Kasirye clarifies that the significant number of stillbirths at their facility is primarily attributed to untreated maternal infections, bleeding, and malaria. “The mentioned occurrences cannot be ascribed to the negligence of healthcare workers, as alleged by specific patients, caregivers, and individuals from the public,” he said.
This website has discovered that the hospital has a shortage of essential medical equipment. Out of the two available scans, one is non-functioning, leaving the facility with only one operational ultrasound machine. Additionally, the hospital lacks an X-ray machine, which is crucial for detecting deformities in expectant mothers.
The hospital’s inventory of essential equipment also faces limitations when it comes to incubators. Presently, Mukono Hospital has a meagre count of two incubators available for use.
Dr. Kasirye acknowledges that these incubators are frequently utilized interchangeably, and at times, due to limited resources, two babies are compelled to share a single incubator.
“The pressing need for adequate healthcare infrastructure to address the current challenges effectively and ensure the safety and welfare of both mothers and infants,” he stressed.
A delegation of legislators representing the district is concerned about the overwhelming cases of stillbirth occurring at the hospital.
Accompanied by Mathias Mpuuga Nsamba, the Leader of Opposition (LOP) in Parliament, the delegation convened Monday to assess the consequences of the stillbirth crisis and emphasized the need for immediate measures to protect the lives of expectant mothers and their unborn children.
They acknowledged that the crisis serves as a stark reminder of the challenges faced by expectant mothers in accessing quality healthcare services in the region.
With stillbirths occurring at or after 20 or 28 weeks of gestation, the loss of these precious lives is not only heart-wrenching but also reflects the systemic gaps that exist within the healthcare infrastructure.
Maternal healthcare, according to the legislators, encompasses a range of services, including antenatal care, skilled birth attendance, emergency obstetric care, and postnatal support.
However, the current situation in Mukono district reveals a shortage of adequately equipped healthcare facilities, a lack of trained healthcare professionals, and limited access to essential prenatal interventions.
“These deficiencies contribute to an increased risk of stillbirths and underscore the pressing need to prioritize the enhancement of healthcare infrastructure,” Mpuuga noted.
Implication
The implications of the Mukono Stillbirth predicament are profound and far-reaching. At an individual level, families are left devastated by the loss of their unborn children, experiencing profound grief and emotional trauma.
The impact extends beyond the immediate bereaved families, affecting the entire community’s social fabric. The dilemma also highlights the broader societal consequences, as stillbirths perpetuate a cycle of poor maternal health and increased morbidity and mortality rates.
“Insufficient care during pregnancy heightens the chances of complications and negative outcomes for both the mother and the surviving children,” a health worker at the Maternity ward said.
Additionally, the economic repercussions are significant, with families facing financial burdens associated with medical expenses, funeral arrangements, and potential loss of income. Thus, addressing the gaps in maternal healthcare infrastructure in Mukono district becomes not only a matter of humanitarian concern but also an imperative for sustainable development and improved social well-being.
Legislators
Mathias Mpuuga (LOP), expressed deep concern and distress over the alarming stillbirth rates. He highlighted the emotional pain experienced by mothers who carry their babies for an extended period of time, only to receive the devastating news that their babies cannot survive.
Betty Nambooze Bakireke, the Member of Parliament representing Mukono Municipality, directed blame towards the hospital management, accusing them of withholding critical information regarding the hospital’s situation whenever inquiries about its status were made.
According to Nambooze, they have consistently sought information from the hospital management regarding the specific needs and deficiencies to advocate for necessary resources since their intention is to remind the government of its responsibility to adequately equip healthcare facilities.
However, she expressed frustration as the hospital management has repeatedly responded with vague or insufficient information, claiming that there is nothing lacking, a claim the hospital management refutes. “The absence of transparency poses a hindrance to their capacity to efficiently advocate for the necessary support and resources from the government,” she said.
Fred Kayondo, the Member of Parliament representing Mukono South County, raises a pertinent question regarding the handling of babies who do not survive due to stillbirth, considering that the hospital’s mortuary is nonfunctional. Dr. Kasirye, in response to this concern, explains that despite the non-functionality of the mortuary, they still utilize it specifically for cases involving stillbirth victims.
Residents’ Painful Account
In 2021, Rose Baisi, a resident of Kigombya village in Mukono district, made a disturbing accusation against the hospital management. She claimed that her baby, who she alleged had died during birth, was cruelly disposed of in a placenta pit by the hospital staff.
Baisi’s distressing experience unfolded when she gave birth to twins at the facility. To her utter shock, the health workers only presented one of her babies to her, without offering any explanation regarding the fate of her ‘second child’.
The absence of information regarding the whereabouts or condition of her second child only intensified her anguish and left her questioning the actions and transparency of the healthcare providers at the hospital.
This incident not only highlights the profound emotional trauma endured by Baisi but also raises concerns about the hospital’s handling of stillbirth cases and their communication with grieving parents.
However, the distressing nature of the situation underscores the pressing need for improved protocols, sensitivity, and transparency in such delicate matters to ensure that parents are provided with accurate information and appropriate support during these devastating experiences.
Causes of Stillbirth
Doctors at Mukono General Hospital highlight several factors that can contribute to stillbirth, although in many cases, the exact cause remains unknown. However, they mention different known risk factors and potential causes that have been identified.
Placental problems: Issues with the placenta, such as placental abruption (when the placenta detaches from the uterine wall prematurely) or placental insufficiency (when the placenta is unable to provide adequate nutrients and oxygen to the baby), can lead to stillbirth.
Fetal abnormalities: Certain genetic or structural abnormalities in the baby can increase the risk of stillbirth. These abnormalities may affect the development of vital organs or systems, making survival impossible.
Infections: Infections in the mother, such as bacterial infections (e.g., Group B Streptococcus), viral infections (e.g., cytomegalovirus, herpes), or intrauterine infections, can increase the risk of stillbirth.
Maternal health conditions: Certain maternal health conditions, such as high blood pressure (preeclampsia), diabetes, obesity, or autoimmune disorders, can contribute to the occurrence of stillbirth.
Placental or umbilical cord abnormalities: Structural issues or abnormalities in the placenta or umbilical cord, such as knots, strictures, or abnormalities in blood vessels, can disrupt the flow of oxygen and nutrients to the baby.
Maternal lifestyle choices: Factors like smoking, alcohol consumption, illicit drug use, and poor nutrition during pregnancy can increase the risk of stillbirth.
Inadequate prenatal care: Insufficient access to quality prenatal care, including regular check-ups, screenings, and interventions, can contribute to the occurrence of stillbirths.
Best solution
Addressing stillbirth requires enhancing healthcare infrastructure, including access to functioning scans, X-ray machines, and incubators. Comprehensive prenatal care, education, and skilled healthcare professionals play vital roles.
Furthermore, strengthening referral systems, collecting data, and conducting research aid in understanding causes and risk factors plus emotional support for parents is essential.
Still, ensuring collaborative partnerships with communities, NGOs, and governments helps mobilize resources and advocate for policy changes. “Implementing these solutions can reduce stillbirths, ensuring expectant mothers receive adequate care and support,” emphasised the health professionals.
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