The condition leads to abortions, death of mother and child
Srinagar: Sakeena Akhtar (name changed) shivers while recalling the incident that unfolded few months ago at her home. She feels choked every time people ask her wellbeing. As Sakeena struggles to speak, her mother suddenly burst into tears moments later and narrated her ordeal.
“Our daughter has suffered a lot. Allah should forgive her and bless her with a baby,” says her mother, Haleema Banu.
The 32-year-old Sakeena of Khag area in central Kashmir’s Budgam district is recovering from the recently conducted abortion at LD Hospital, Srinagar.
“It’s not the first time when doctors informed her about complications with her womb. However, she has gone through this painful phase twice in last one year of marriage,” Haleema told Kashmir Reader.
She said the repeated episodes shocked the family and left them in distress as they have been apprehensive about her future pregnancies as well. “After consulting a senior gynecologist in Lal Ded Hospital, we finally came to know that our daughter is suffering from severe anemia which is leading to the repeated abortions,” the mother said.
“Now, the doctors at LD Hospital started her treatment and we are hopeful that she can give birth normally,” Haleema said.
Iron deficiency, or anemia as it is known, is a condition where lack of iron in the body leads to reduction in the number of red blood cells.
“Iron is used to produce red blood cells, which help store and carry oxygen in the blood. If you have fewer red blood cells than is normal, your organs and tissues will not get as much oxygen as they usually do,” said Dr Rizwana Habib, Professor at the Department of Gynecology and Obstetrics, Government Medical College (GMC) Srinagar. She said that iron and nutrients are crucial in the development of a foetus’ brain, meaning their deficiency could lead to many complications. Dr Rizwana said that people in far-flung areas are usually unaware of the complications during pregnancy.
“People of these areas usually ignore the alerts by doctors. They wake up only after the damage is done,” she believed.
Dr Rizwana said the iron deficiency and its resultant anemia is the most common nutrient deficiency, especially during pregnancy, affecting most of the women in Kashmir and their infants.
“Iron, folic acid and vitamins are crucial nutrients for early brain development, contributing to neurotransmitter production and immune functions. Its deficiency leads to the abortions, heart failure, and hypertension,” she said.
“So, women should take supplement of iron and vitamins during pregnancy, and go for regular check-up by doctor about how to address the problems,” she advised.
The report released by Ministry of Health and Family Welfare last year reveals that nearly 60 percent pregnant women in Jammu and Kashmir suffer from anemia.
The data shows that anemia is widely prevalent among all groups and is particularly high among the pregnant women.
As per the data, over 16000 pregnant women out of 26994 registered by health institutions in October 2015 were found anemic.
“14552 pregnant women suffer from mild anemia with hemoglobin (Hb) level less than 11 while 1496 suffer from severe anemia,” the report reads.
In the latest report, the health ministry reveals that in Budgam nearly 55 percent pregnant women suffer from mild to severe anemia. “Nearly 9537 pregnant women suffer from anemia with a Hemoglobin level less than 11 in most of the cases among 17539 women registered for three antenatal checkups during April 2014 to January 2016,” the data reveals.
Anemia is a condition where the human body has less than the normal level of hemoglobin which compromises the oxygen-carrying capacity of blood cells.
Anemia in pregnant women not only poses maternal mortality risk but also stunted the growth of the born children.
The report further reveals that 1099 pregnant women in Budgam had obstetric complications and were treated at public facilities including primary health centers, community health centers, sub-district hospitals, district hospitals and other state owned public institutions.
As per the data, there is a rising incidence of malnutrition-related diseases among women as compared to men and children.
“126 cases were having hemoglobin less than 7gm/dl and over 950 cases of complicated pregnancies treated with blood transfusion were reported in last two years in Budgam,” the data revealed.
5960 live births were reported in last two years (till 2016) which is only 34 percent of the total antenatal registrations.
“During the last two years (till January 2016) nearly 590 abortions (both spontaneous and induced) were reported in Budgam district,” the report said.
Anaemia is a global public health problem affecting developed and adversely affecting developing countries. The highest prevalence of anemia exists in the developing world, where its causes are multi-factorial.
“The prevalence of anemia varies according to the socio-economic status, dietary deficiencies, Cultural taboos, infections, multiple pregnancies, low contraceptive prevalence, and with all these hemoglobinopathies is an additional factor,” said Dr Rizwana.
She said common type of anemia was iron deficiency, this is a nutritional deficiency disorder and the pregnant women are highly vulnerable population particularly with its frequent risks even with first pregnancy. “Anemic pregnant women are prone to severe morbidity and mortality. Consequences with a milder form of anemia are “silent”, without symptoms. In its severe form, anemia is associated with symptoms like fatigue, weakness, dizziness and drowsiness,” she said.
It may further include loss of normal color in the skin (in fair-skinned people) and also in the lips, tongue and nails.
As per literature about 20 percent of maternal deaths are caused by anemia and with this anemia is an additional risk factor in the contribution of 50 percent of all maternal deaths world over.
“There are three main reasons for death due to anemia First, anemia results from excessive blood loss during or after delivery resulting in low hematological reserves,” said another senior gynecologist, Dr Masooma Rizvi.
Second, with severe anemia resistance is decreased and susceptibility to infection is increased; and third, hemoglobin (Hb) level of less than 4 g/dl is associated with high risk of cardiac failure and death particularly during delivery or soon after.
The UNICEF links the health risk to the poor status of adolescent girls and their poor diet which according to them perpetuate a vicious cycle of nutrition deprivation that passes on from mother to daughters, from one generation to the next.