Poverty drives maternal mortality in the Philippines

Poverty drives maternal mortality in the Philippines

Francisco Sales believes he could have saved the lives of his wife Gloria Operario and their unborn child during childbirth three years ago if he had enough money.

Gloria had a risky third pregnancy due to gestational diabetes and high blood pressure and needed special treatment in a good hospital, which the poor couple could not afford.

Just like Gloria, each year at least some 2,500 women die in the Philippines due to complicated pregnancy and childbirth, mostly because of poverty.

Pediatrician Jerilee Cledera says cases like that of 30-year-old Gloria are common. Cledera said babies whose mothers are diabetic may have excessive birth weight, making normal delivery almost impossible. A cesarean section delivery is advised in such cases, she said.

But a C-section costs about 120,000 pesos (US$2,154) in the Philippines and Francisco’s family, who live on the outskirts of Naga City,  could not afford it.

Francisco, 32, earned some US$325 monthly from his carpentry work and Gloria earned some US$200 from a convenience store she managed. 

The income was hardly enough for the family with two children and financial struggles forced them to avoid expensive medical check-ups for Gloria. For emergencies, they depended on a local health center in their neighborhood.

For the delivery, just like in the past two childbirths, they engaged a midwife to conduct the delivery at home in August 2019.

The midwife tried for seven hours but a frail Gloria collapsed unable to deliver her baby. She was rushed to a hospital but the mother and the child died on the way, Francisco said.

“We thought we could do it like in two previous pregnancies, with the help of Ina (Mother Mary in Bicol),” Francisco recalled.

Naga City, also known as Pilgrim City, is famed as the home of the Our Lady of Peñafrancia, a century-old image of Mary, brought by Dominican missionaries in the Philippines in the 1680s.

Francisco said they believed the miraculous Marian image has healing power and her blessing could help pass the delicate pregnancy.

Maternal mortality in the Philippines is often linked to poverty and lack of facilities, studies show.

Some 20 million people — 18 percent of the country’s 113 million population — were living in poverty in 2021,  Asian Development Bank said.

Each day at least six women died of complicated pregnancy and childbirth in 2021, shows data from the Philippine Statistics Authority.

The maternal mortality rate was 189.21 per 100,000 live births. At least 2,478 women died because of complicated pregnancies or childbirth in 2021, the government data said.

Observers say the actual figure of maternal mortality is much higher as many cases, especially in rural areas, are not reported.

The official 2021 death rate is closer to the highest number of maternal deaths reported in the country seven decades ago — 2,645 maternal deaths in 1951 and 2,511 in 1952.

Health experts say a jump in such deaths in 2021 from 1,498 cases in 2019 is due to a lack of available health facilities during the Covid-19 pandemic.

“The increasing rate of their mortalities in the past two years has been indicative of the difficulties in obtaining services related to maternal and newborn health,” Lolito Tacardon from the state-run Commission on Population and Development told UCA News.

Rampant corruption and political foul-play in the Catholic-majority nation often deprive the needy of services.

In 2020, a corruption scandal rocked the Philippine health insurance system when the country’s Commission on Audit reported more than 14 billion pesos (US$288.7 million) were illegally released to hospitals for Covid-19 benefits.

The Department of Health was accused of mishandling 67.21 billion pesos (US$1.22 million) Covid funds for overpriced face masks and protective gear.

Tacloban City Mayor Alfred Romualdez told UCA News budget allocation is also an issue. The national government allocates a budget. “So, if you’re not an ally of those in power, you will not have millions needed to hire more doctors and buy more medical equipment.”

Romualdez cited that the growing population means all municipalities need regular funding for vital services like healthcare.

Obstetrician and Gynecologist Cristopher Soriano alleged that a minimum standard of health care was not being provided to the people because of the confluence of medicine and politics.

“When there is corruption and the money allocated to hire more doctors goes into the pockets of politicians, then people like Francisco and Gloria suffer the most,” Soriano told UCA News.

Back in Naga City, Francisco said he struggles to support his two children, Pedro, 9, and Easter, 7.

Gloria should not remain a number among the thousands of such mothers but a wake-up call for the government to ensure affordable healthcare to the poor, he said.  

“My wife and child could be alive had there been access to free doctor visits, medicines, and affordable facilities,” he exclaimed.