KIGONDU AND MUTUKU: Harnessing timely interventions to reduce maternal mortality in Sub-Saharan Africa

Issabelah Mutuku is a Communications Officer at the African Population and Health Research Center, and Dr. Simon Kigondu is a practicing consultant gynaecologist and the President of the Kenya Medical Association (KMA)

Despite progress in global maternal health, every day, women across sub-Saharan Africa continue to face life-threatening complications, with some leading to death during childbirth.

Behind each maternal death is a name, a face, and a family left devastated.

These misfortunes often stem not from rare complications but from a lack of timely and adequate obstetric care.

In 2023, the World Health Organization (WHO) reported that maternal mortality in low-income countries stood at 346 per 100,000 live births compared to 10 per 100,000 in high-income countries.

Access to trained professionals, emergency care, and lifesaving interventions such as cesarean sections can make a significant difference in reducing maternal and newborn mortality.

A cesarean section, commonly known as a C-section, is a surgical procedure used to deliver a baby through incisions in the mother’s abdomen and uterus, often performed when vaginal delivery poses a threat to the health of the mother or child.

If administered for medically indicated reasons, C-sections can effectively prevent maternal and newborn mortality.

A C-section is often recommended to women who have medical conditions that affect their pregnancy, such as obstructed labor, severe pre-eclampsia, fetal distress, and complications like placenta previa.

These conditions can often be identified early during routine antenatal visits, allowing for timely intervention and management.

With proper prenatal care, healthcare providers can anticipate and address these risks, ensuring that women receive the appropriate care and reducing the likelihood of life-threatening complications during childbirth.

In many rural areas, barriers to accessing cesarean sections remain a significant challenge. Emergency obstetric care is often scarce, and women in labor are forced to travel long distances to reach health facilities equipped to perform C-sections.

Even when they arrive, some facilities often lack adequately trained personnel to carry out the procedure, further compromising timely and safe delivery.

According to the WHO, C-section rates should range between 10–15 per cent of all births to effectively reduce maternal and newborn mortality. However, this target remains unattainable for many women, particularly those from low-income households.

While women from financially well-off households often meet or exceed the recommended rates, those from less privileged communities remain far below. This brings about inequality in access to maternal care services.

Life-saving interventions like C-sections should be based on medical need but not on one’s ability to pay.

Dr. Simon Kigondu, an obstetrician-gynecologist with over two decades of surgical experience, notes that while C-section is among the most commonly performed obstetric procedures, it should never be taken lightly.

He explains that C-sections can be unpredictable, carrying risks associated with anesthesia, bleeding, and complications, particularly in repeat procedures where the anatomy may have changed.

Dr. Kigondu emphasizes the importance of thorough preparation and ensuring that the procedure is carried out by well-qualified personnel in adequately equipped facilities capable of managing any unforeseen challenges.

He further adds that while a C-section can be life-saving, it can also become life-threatening when things go wrong.

Beyond infrastructure and human resources, cultural beliefs also pose significant barriers to accessing C-sections.

In some communities, C-sections are stigmatised, with women who undergo them perceived as weak or as having failed at childbirth.

These harmful misconceptions, often driven by myths and misinformation, can delay timely decision-making at critical times and ultimately cost lives.

To improve maternal health outcomes, these barriers need to be well addressed. Women of reproductive age have a right to access sexual and reproductive healthcare.

Governments should invest in and allocate adequate funds to strengthen maternal health infrastructure, including in rural areas.

Health facilities across the country should be equipped with the necessary medical equipment, and more birth attendants should be trained in emergency obstetric care to ensure timely and effective interventions.

As we observe this cesarean awareness month, there is need to raise more awareness among the public to dispel myths and misinformation around surgical births.

Every mother’s life is precious, and every safe delivery is a testament to what is possible when we prioritise women’s health.

Issabelah Mutuku is a Communications Officer at the African Population and Health Research Center, and Dr. Simon Kigondu is a practicing consultant gynaecologist and the President of the Kenya Medical Association (KMA).