KARACHI, May 20: About 45 per cent of the Pakistani women develop anaemia during pregnancy, a research paper published in a medical journal says. This shows that an overwhelming number of the women are grossly undernourished during pregnancy, and perhaps even before and after it.

The study on which the paper is based was undertaken by Gulshan Ara Syed, Nasim Khattak and Rehana Hamid and involved 7,000 deliveries. According to the paper — published in the latest issue of Medical Channel journal which is recognized by the Pakistan Medical and Dental Council — the incidence of pre-term labour in deliveries involving anaemic women was about ten per cent higher than those involving non-anaemic women.

And the mean weight of the children born to anaemic women was about 0.5 to 0.3kg less than the children born to other groups of women. Thus the children born to non-anaemic women get a clear head start in terms of health as compared to those born to anaemic women.

These are significant findings as they point towards a vicious cycle in which malnourished, and apparently poor, women give birth to low-weight babies who lag behind the offspring of healthier women. According to some studies, 25 per cent of all Pakistanis are born with low weights.

One way to address the above problems, according to Yasmin Rashid of the central chapter of Pakistan Medical Association, is to provide iron supplements to pregnant women. These supplements cost less than Re1 per tablet or capsule.

“But some families are so poor that they cannot even afford to spend Re1 every day on the pregnant woman,” said Ms Rashid. “On the other hand, the families that do have the money may or may not attach enough importance to keeping the pregnant woman sufficiently nourished.”

To be sure, anaemia is not the only problem that is faced by the pregnant women. Haemorrhage, infections, eclampsia, obstructed labour and ruptured uterus are among the host of other complications that stare them in the face.

In Pakistan, India and Bangladesh more than 40 per cent of the maternal deaths are due to the said complications. And what is the number of Pakistani women who die due to pregnancy-related complications?

Well, according to the Unicef and WHO, the maternal mortality ratio (MMR) for Pakistan is 340 per 100,000 live births. The National Committee for Maternal Health (NCMH), however, says the actual figure is between 500 and 600 per 100,000 live births.

Some estimates place the total number of Pakistani women dying in pregnancy-related complications at 30,000. This translates into a maternal death every 20 minutes or so.

So what should be done to make pregnancy safe? Some of the steps proposed by the NCMH are: — Reduce the number of high risk pregnancies, like teenage pregnancy and also the unwanted or undesirable one; — Use family planning methods to reduce the number of pregnancies; — Reduce the number of complications through antenatal care, and; — Ensure safe deliveries through attendance of trained health-care providers during them.

The NCMH recommends that in case of complications, treatment and care should be sought at facilities capable of providing emergency obstetrical care (EmOC). Trained midwives could play a vital role in reducing maternal deaths but unfortunately they are not available in sufficient numbers.