The unseen battles of childbirth that plague mothers

Most of the health complications include haemorrhage, fistula, postpartum depression, and numerous others that, if left untreated and undiagnosed, can pose significant risks.

Bringing a baby into the world is often a joyful moment for couples, but sometimes it can unexpectedly bring challenges, as Veronika* experienced.

Veronika, a 40-year-old from Nairobi, faced complications during her third pregnancy that led to her being rushed to the hospital. Sadly, after giving birth, she developed epilepsy.

"It all changed after my third child arrived four years ago," Veronika explains. "I never had any health issues before, but then epilepsy came into my life, altering everything."

Navigating daily life with epilepsy has been tough for Veronika. She recounts the uncertainty and fear others feel when she experiences seizures.

"It's hard to find work when people are afraid of the unknown. I've tried, but I always end up being let go because of my condition."

Instead, Veronika finds herself at home, focusing on caring for her children due to the unpredictability of her seizures. "This illness has turned my world upside down. I've had accidents, like falling into a fire, leaving me covered in bruises," recounted Veronika.

Despite seeking medical help, Veronika's condition remains unchanged, leaving her frustrated and disillusioned.

"I've tried different treatments, but nothing seems to work. It's disheartening," said Veronika.

Dr Faiza Ali from Zazi Medical Centre in Eastleigh highlights the crucial role antenatal care plays during pregnancy.

"When an expectant woman neglects clinic appointments, it becomes challenging to identify potential issues. Monitoring blood pressure is especially vital because if left unchecked, it can lead to the onset of preeclampsia or even eclampsia," said Dr Faiza.

"Preeclampsia" is a pregnancy complication characterised by high blood pressure and signs of damage to other organ systems, typically the liver and kidneys.

It usually begins after 20 weeks of pregnancy in women whose blood pressure has been normal. Symptoms may include high blood pressure, swelling, headaches, abdominal pain, and vision changes. Preeclampsia can lead to serious, even fatal, complications for both the mother and baby if left untreated.

"Eclampsia" is a serious complication of pregnancy characterised by the onset of seizures, typically preceded by symptoms of preeclampsia such as high blood pressure and protein in the urine. It is a life-threatening condition that requires immediate medical attention.



Antenatal care

Dr Faiza emphasises the importance of antenatal care to monitor blood pressure and prescribe appropriate medication to prevent further complications.

While many assume that epilepsy is solely transmitted genetically, it can also result from preeclampsia.

"High blood pressure during pregnancy can progress to eclampsia, the final stage of which may manifest as epilepsy," said Faiza.

Other health complications include haemorrhage, fistula, postpartum depression, and numerous others that, if left untreated and undiagnosed, can pose significant risks.

While epilepsy has long been stigmatised and often attributed to genetic factors, there are instances of women developing the condition during pregnancy.

According to WHO, epilepsy is a significant global health concern, affecting approximately 50 million people worldwide, with approximately 80 per cent of them residing in low- and middle-income countries.

In low-income countries, about three-quarters of people with epilepsy may not receive the treatment they need, contributing to what's known as the "treatment gap." This gap is due to factors such as low availability of antiseizure medicines and insufficient healthcare infrastructure.

Seizures

Potentially preventable causes of epilepsy include those resulting from falls, drowning, burns, and prolonged seizures.

WHO highlights that the causes of epilepsy vary and include structural, genetic, infectious, metabolic, immune, and unknown factors. Examples of potential causes include brain damage from prenatal or perinatal causes, congenital abnormalities, severe head injuries, strokes, brain infections, genetic syndromes, and brain tumours.



Seizures can be controlled with appropriate use of antiseizure medicines, with up to 70 per cent of people with epilepsy potentially becoming seizure-free. However, access to treatment is limited, particularly in low-income countries. Training primary healthcare providers to diagnose and treat epilepsy can help reduce the treatment gap.

An estimated 25 per cent of epilepsy cases are potentially preventable. Prevention strategies include measures to prevent head injuries, adequate perinatal care to reduce birth injuries, controlling fever in children, reducing cardiovascular risk factors to prevent stroke-related epilepsy, and eliminating parasites in tropical areas to prevent infections like neurocysticercosis.

Epilepsy accounts for more than 0.5 per cent of the global burden of disease, with significant economic implications in terms of healthcare needs, premature death, and lost work productivity. The financial burden can be alleviated through public financing for medical costs.

Various challenges can accompany childbirth, such as postpartum haemorrhage, preeclampsia, or infection.

Mercy* has been grappling with postpartum depression for the past year after giving birth to a child with a profound cleft palate, which has affected his feeding.

"It's incredibly painful to witness your child struggle with malnutrition because they're unable to feed properly, and feeling utterly helpless about it. Often, my husband couldn't grasp the depth of my emotions, and I found myself in tears as I tried to sleep, with no one to confide in," said Mercy.

Often, people fail to grasp the stress that accompanies being a first-time mother, especially when compounded by the challenge of giving birth to a child with a disability.

According to BMC pregnancy and child journal publication 1 out of every 10 women experience postpartum depression following childbirth, with some studies suggesting the figure to be as high as 1 in 7 women.

The duration of postpartum depression spans from 3 to 6 months, although this timeline can vary depending on various factors.

An estimated 50 per cent of mothers with postpartum depression do not receive a formal diagnosis from a healthcare professional 80% of women grappling with postpartum depression ultimately achieve complete recovery.