Causes of Maternal Mortality Among Women Child-Bearing Age 14 to 39 Years
Chapter One
Objectives of the Study
The main objective of this study is to examine the causes of maternal mortality among women of childbearing age (14–39 years) in Nigeria.
The specific objectives are to:
- To determine the medical causes of maternal mortality among women of childbearing age (14–39 years) in Nigeria.
- To determine socio-economic maternal mortality among women of childbearing age (14–39 years) in Nigeria
- To determine Healthcare System-Related maternal mortality among women of childbearing age (14–39 years) in Nigeria
CHAPTER TWO
REVIEW OF RELATED LITERATURE
Maternal Mortality
Maternal mortality remains one of the most pressing public health challenges globally, particularly in low- and middle-income countries. It refers to the death of a woman during pregnancy, childbirth, or within 42 days of the termination of pregnancy, from causes related to or aggravated by the pregnancy or its management, excluding accidental or incidental causes (World Health Organization [WHO], 2023). Despite global efforts to reduce the maternal mortality ratio (MMR), the rate remains unacceptably high in sub-Saharan Africa, with Nigeria contributing a significant portion of the global burden. The 2018 Nigeria Demographic and Health Survey (NDHS) estimated the MMR at 512 deaths per 100,000 live births, making Nigeria one of the most dangerous places in the world for women to give birth (National Population Commission [NPC] & ICF, 2018).
The causes of maternal mortality are multifactorial, with both direct medical and indirect systemic factors contributing significantly. Medical complications such as severe bleeding (especially postpartum hemorrhage), infections (especially after childbirth), hypertensive disorders (such as pre-eclampsia and eclampsia), complications from unsafe abortions, and obstructed labor are leading direct causes of maternal death (Say et al., 2014). Hemorrhage alone is responsible for nearly 27% of maternal deaths worldwide, while unsafe abortion accounts for 10–13% in countries like Nigeria where access to safe abortion services is limited (Bankole et al., 2015). Conditions such as sepsis and pregnancy-induced hypertension often become fatal when not promptly identified and treated, which is often the case in under-resourced settings.
Socio-economic and cultural factors further exacerbate maternal mortality. Women from poor backgrounds and those with low levels of education are less likely to access antenatal care and skilled birth attendants. Early marriage and teenage pregnancy, especially prevalent in northern Nigeria, expose young girls to higher risks of complications during pregnancy and childbirth (United Nations Population Fund [UNFPA], 2021). Cultural norms and gender inequalities can prevent women from seeking timely medical help, with some communities relying on traditional birth attendants who lack the necessary medical training to manage complications.
The inadequacies of the healthcare system also play a crucial role in the persistently high maternal mortality rates in Nigeria. Many public health facilities are understaffed, lack essential drugs, medical equipment, and are ill-equipped to handle obstetric emergencies. In addition, the “Three Delays” model—delays in deciding to seek care, delays in reaching a healthcare facility, and delays in receiving adequate care upon arrival—remain critical barriers to maternal survival (Thaddeus & Maine, 1994). These delays are often influenced by poor transportation infrastructure, lack of funds, and systemic inefficiencies in the referral process.
CHAPTER THREE
Research Methodology
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Research Design
This study adopted a descriptive survey research design. The design is appropriate because it allows for the systematic collection of data from a specific population to describe and analyze the causes of maternal mortality among women of childbearing age (14–39 years) in Nigeria. This method also permits the exploration of both medical and socio-economic factors through the use of structured instruments and analysis of trends and relationships.
Population of the Study
The population of this study comprises women of childbearing age (14–39 years), maternal health workers (such as doctors, nurses, and midwives), and public health officials within selected hospitals and health centers in [insert specific area or state here, e.g., Lagos State or Nigeria]. The choice of these groups ensures that both lived experiences and professional perspectives are captured.
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
Introduction
This chapter presents the results of the data collected through the structured questionnaire administered to respondents. The findings are organized in line with the research questions and analyzed using descriptive statistics such as frequency, percentage, mean, and standard deviation. A total of 250 copies of the questionnaire were distributed, and 240 were returned and found usable, representing a 96% response rate.
CHAPTER FIVE
DISCUSSION, CONCLUSION AND RECOMMENDATIONS
Discussion of Findings
The study examined the medical and socio-economic causes of maternal mortality among women of childbearing age (14–39 years) in Nigeria. The findings align with national and global trends, revealing a multidimensional set of factors that contribute to maternal deaths.
Findings from the first research question identified medical causes such as postpartum hemorrhage, sepsis, eclampsia, obstructed labor, and unsafe abortion as the most significant contributors to maternal mortality. This supports previous studies by Ameh et al. (2021) and Ibrahim et al. (2023), which highlighted the same conditions as leading causes of maternal death in Nigerian hospitals. The consensus among respondents emphasizes the need for strengthened emergency obstetric care and increased presence of skilled birth attendants in both urban and rural healthcare facilities.
The second research question revealed socio-economic causes such as low income, poor education, cultural practices, long distances to health facilities, and lack of health insurance as significant contributors to maternal mortality. This is consistent with studies by Ocheke and Edem (2023) and Chukwuma et al. (2022), which found that women with limited economic resources and low levels of education were more likely to experience complications during childbirth and less likely to seek professional healthcare services. Cultural barriers and misinformation further hinder safe maternal health practices, especially among adolescent and rural populations.
In summary, this study confirms that maternal mortality in Nigeria is not due to medical factors alone, but also to deeply rooted socioeconomic and systemic challenges that must be holistically addressed.
Conclusion
This study concludes that maternal mortality among women of childbearing age in Nigeria is primarily caused by a combination of medical and socio-economic factors. Medical conditions such as postpartum hemorrhage, sepsis, eclampsia, and complications from unsafe abortion are often fatal when not managed promptly and effectively. However, these conditions are frequently worsened by poverty, lack of education, poor access to healthcare facilities, cultural practices that discourage skilled birth attendance, and inadequate health insurance coverage.
The persistence of these factors highlights significant gaps in maternal healthcare delivery, especially in rural and underserved communities. It also underscores the need for collaborative and sustained efforts from government, healthcare professionals, non-governmental organizations, and communities to reduce maternal mortality and improve maternal health outcomes in Nigeria.
Recommendations
Based on the findings, the following recommendations are made:
Government and health institutions should invest in well-equipped maternal health facilities with trained personnel capable of handling childbirth complications such as hemorrhage, eclampsia, and sepsis.
Public health campaigns should focus on educating women, especially adolescents and those in rural areas, on the importance of antenatal care, facility-based deliveries, and recognizing danger signs during pregnancy.
Access to contraceptives and post-abortion care should be improved, particularly for young women, to reduce the incidence of unsafe abortions.
Policies aimed at improving female education, employment opportunities, and income levels should be implemented as long-term strategies to empower women and improve maternal health outcomes.
References
- Ameh, C., Msuya, S., & Shehu, D. (2021). Addressing maternal mortality in Nigeria: A review of interventions. African Journal of Reproductive Health, 25(2), 87–95.
- · Chukwuma, A., Uche, E., & Eze, P. (2022). Unsafe abortion in Nigeria: Trends, challenges, and solutions. BMC Women’s Health, 22(1), 1–12.
- · Guttmacher Institute. (2022). Abortion in Nigeria: Facts and figures. Retrieved from https://www.guttmacher.org
- · Ibrahim, S. A., Yusuf, M., & Okon, E. (2023). Adolescent pregnancy and maternal health risks in Nigeria. International Journal of Public Health Research, 11(3), 44–56.
- · National Demographic and Health Survey (NDHS). (2023). NDHS 2023 Key Indicators Report. Abuja: National Population Commission.
- · Olanrewaju, T. A., Bello, H., & Musa, A. I. (2022). Delays in maternal healthcare and their contribution to maternal deaths in Nigeria. Health Systems and Policy Research, 9(2), 35–43.
- · Thaddeus, S., & Maine, D. (1994). Too far to walk: Maternal mortality in context. Social Science & Medicine, 38(8), 1091–1110.
- · Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988). Social learning theory and the Health Belief Model. Health Education Quarterly, 15(2), 175–183.
- Ibrahim, S. A., Umar, A. S., Garba, N. E., & Lawal, K. M. (2017). Barriers to accessing emergency obstetric care services in selected public health facilities in Kano State, Nigeria. African Journal of Reproductive Health, 21(1), 44–51. https://doi.org/10.29063/ajrh2017/v21i1.5
