First, the numbers: In 2015 twice as many mothers died giving birth in Kyrgyzstan as in Uzbekistan and six times as many as in Kazakhstan. More than 15 years ago, in 1999, there were 72 deaths of mothers per 100,000 live births in Kyrgyzstan, in 2006, that number increased, jumping to 90 deaths per 100,000 births.
Twice as many mothers have died due to pregnancy and childbirth in Kyrgyzstan than in Uzbekistan over the last 25 years. The change of maternal mortality rate in Kyrgyzstan has been 4 times less than in Uzbekistan, 12 times less than in Kazakstan and 15 times less than globally for last 25 years. Kazakhstan decreased the maternal mortality rate by 84 percent while Kyrgyzstan decreased only by 7 percent during the last 25 years.
Millenium Development Goal 5 (MDG5) for Kyrgyzstan in 2015 was 25 and it did not reach this rate in 2015. The rate in 2015 was 76, that is 3 times as many as MDG5.
According to the Ministry of Health of Kyrgyz Republic and a UNDP study in 2013, mothers in rural areas of Kyrgyzstan were twice as likely to die giving birth as mothers in urban areas. Since 2000, there has been a decline in maternal mortality among urban women from 60.3 in 2000 to 32.1 in 2010; at the same time, there has been a significant increase in maternal mortality among rural women from 39.4 in 2010 to 61.3 in 2010. According to 2010 data, the maternal mortality rate among rural women across Kyrgyzstan in general is twice as high as that of women living in urban areas.
In particular, poor women living in rural areas and young women are exposed to high risks during pregnancy and childbirth. Many causes can be attributed to poor healthcare infrastructure in regions, hindered access to clean water and sanitation, electricity and heating and the poor condition of roads. In addition, there is inadequate capacity in Family Group Practitioners (FGPs) and family medical centers, especially in remote and rural areas. Other adverse factors include inadequate nutrition of pregnant women, leading to the emergence of diseases such as anemia that also increase the risk of maternal death in childbirth.
In 2012, half of all births in the country reported various complications due to anemia and other preventable causes. Internal and external migration are also negatively affecting maternal health. Migrant women often remain beyond the reach of counselling and care by health practitioners, a fact that worsens the chances of successful outcomes during pregnancy and birth. There is a growing number of deaths during childbirth among migrant women who moved from rural areas to other regions (Bishkek, Chui oblast, oblast centres) and outside the country.
Is 50 the new 40 for motherhood?
According to Global Burden of Disease Study 2013, mothers of 35 years and older die three times more than mothers 35 years and younger.
Mothers in Kyrgyzstan die from easily preventable causes:
Mothers in Kyrgyzstan die from bleeding, from abortions and from becoming mothers later in life both of which are preventable. According to the Ministry of Health of Kyrgyz Republic and UNDP study in 2013, maternal mortality is increasingly impacted by non-medical causes. Low public awareness, especially in rural areas, of methods of family planning, of reproductive health and safe contraceptives, of the danger signs of pregnancy, and of the importance of timely health care, as well as family members’ lack of awareness of danger signs during pregnancy, combined with poor nutritional habits, inadequate rest, and insufficient preparation for childbirth, all leading to the increased incidence of complications during pregnancy. Inadequate standards and services regarding sex education for students, teenagers and young people and forced refusal of access to contraception due to religious reasons lead to pregnancy and childbirth at an early age.
Elira Turdubaeva, Department of Journalism and Mass Communications American University of Central Asia