Three years after the start of the Covid-19 pandemic, a period in which maternal mortality rates in Brazil doubled, returning to the levels registered 25 years ago, pregnant and postpartum women are more protected against Sars-CoV -2. However, they die again from causes such as hypertension, bleeding and infections, considered preventable in 90% of cases.
The country already suffered many weaknesses in obstetric care, but with the health crisis, they intensified. One of the most important indicators is the cause of maternal mortality (RMM), which computes deaths related to complications during pregnancy and up to 42 days after delivery (puerperium). In 2021, the RMM indicated that, for every 100,000 live births, there were 110 female deaths, the same rate registered in 1998. Preliminary data from the Ministry of Health, compiled by the OOBr (Observatório Obstetrico Brasileiro), show that the number it is almost double that in 2019, the period before the pandemic, when the proportion was 57.9 deaths. In 2020, the official rate was 71.9 deaths per 100,000 live births.
In absolute numbers, 1,964 deaths were reported in 2020 and 2,941 deaths in 2021. Data for 2022 are not yet consolidated. For comparison purposes only, there were 861 maternal deaths in the United States in 2020 and 1,178 in 2021, according to the CDC (Centers for Disease Control and Prevention). Together, they account for less than half of the Brazilian deaths during this period.
Brazil is a signatory to an agreement signed with the UN in 2015 to reduce, by 2030, the maternal mortality rate to a maximum of 30 per 100,000 live births, that is, almost a quarter of that registered in 2021. A report by 2019 from the Ministry of Health obtained by Sheet reveals that there is a 95% chance that the country will not reach the goal. The RMM calculated by the Ministry’s technicians for 2030 is 55.6 deaths per 100,000 live births.
The newspaper toured cities in the north of the country, a region with a mortality rate of 140.8 deaths per 100,000, the highest in the country, interviewed health professionals, managers and, mainly, families who lost pregnant women and found a series of problems in the maternal and child care network.
Roraima led the ranking of maternal mortality in 2021, with 281.7 deaths per 100,000 live births, a level similar to that of sub-Saharan African countries, such as Mozambique. In developed countries, this rate is around 10 per 100,000.
The death of Thais Kauana Rodrigues Diniz, 21, and her baby, in Boa Vista (RR), exemplify some of the weaknesses of the system. The young woman lived in a mining area, she was in the 19th week of pregnancy, but she had not attended prenatal consultations. She arrived at the Nossa Senhora de Nazareth maternity ward on January 12 with abdominal pain and loss of amniotic fluid. The maternity part of her performs impromptu in tents of a field hospital. The original building has been undergoing renovation since June 2021.
On the tenth day of Thaís’ admission, it was found that the fetus had died in the womb, according to her aunt, Alessandra Araújo. The death of the baby is added to another 27 registered in the maternity hospital from the beginning of this year until February 7. In 2022, there were 20 deaths. “She spent two days suffering after receiving medication to induce labor. She no longer wanted to eat, her belly began to swell, she just moaned in pain. I asked for help, it was clear that she was getting worse, but they told me that the swelling was gas accumulation The situation there is chaotic,” says Alessandra.
Already in serious condition, Thaís was transferred to the General Hospital of Roraima, the only SUS with an ICU in the capital. Examinations revealed uterine rupture and generalized infection (septicaemia). She was operated on, intubated, and died two days later, on January 27. The maternity denies that there was negligence in care. As for the deaths of babies, the State government assures that the causes are diverse, “a part of them related to the lack of adequate prenatal care.” Regarding the maternity wing, he assures that the building’s remodeling services are in the final phase.
Maternal Mortality Feature Series is published in collaboration with the Pulitzer Center
Translated by AZAHARA MARTIN ORTEGA
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