Article reference: How inequity threatens the lives of pregnant women: barriers to accessing health services during an incomplete miscarriage in rural southern Mexico. Karen Gutiérrez-Peláez, Zeus Aranda, Andrea Jiménez-Peña and Hellen Mata-González
The case report “How inequity threatens the lives of pregnant women: barriers to accessing health services during an incomplete miscarriage in rural southern Mexico” by Karen Gutiérrez-Peláez et al. presents barriers to women’s health which are not only relevant to low and middle income countries but also to first world countries.
The inequality in women’s health is something we struggle with globally, including the issue of rights to safe abortion an issue that has been put back on the table in the United States of America. Protecting women’s access to proper healthcare facilities before during and post partum is crucial to the community at large and ensuring its future.
Pelaez et al. mentions transportation as a key obstacle in being able to access tertiary health care facilities often found hours away from the most in need rural communities. Certain countries, such as Israel, provides free ambulance transfers to a hospital for women in labor and 72 hrs post partum to encourage in hospital birth and monitoring. If we extrapolate this idea, a government subsidized transportation system for women during the time of pregnancy and post partum could allow for specialized personnel in transport as well as at destination. In this case report we see the patient having to be moved from one health facility to another prolonging the time to proper diagnosis and treatment. The idea mentioned in the case report of using locals to help transfer patients to hospitals could also help benefit the community.
Another point brought up here is the lack of access to phone and internet precluding from the use of tele heath which could be incredibly useful in these communities. Consultation with a gynecologist as well as timely initial diagnosis could be made in a timely manner.
Training of local healthcare workers, in obstetric emergencies could help save lives. As mentioned hypertension and hemorrhage, both reversible causes of morbidity and mortality could be diagnosed easily in a basic medical clinic. Initial treatment with anti hypertensives and/or fluids do not require high levels of training. The government should prioritize such educational programs from medical staff in rural areas which play a key role in assuring access to health for these underserved communities.
Women in resource poor and remote geographical areas are not only bread winners but also home makers, mothers and are the key to procreation. If more is not done to assure their wellbeing during their child bearing the morbidity and mortality will continue to be elevated, removing key figures from these communities.
About the author:
Chloe Pinto M.D., Resident in anesthesiology at Meir Medical Center in the department of Anesthesia, Critical Care and Pain medicine.
Declaration of interests
I have read and understood the BMJ Group policy on declaration of interests and declare the following interests: None