By Ali Nawaz Rahimoo
Behind every maternal death lies a tragedy that extends far beyond the loss of a life. It leaves behind a grieving family, a child growing up without a mother and a community deprived of one of its most essential pillars of care and stability. Although the world has made progress in reducing deaths related to pregnancy and childbirth, thousands of women continue to die every year from causes that are largely preventable. In Pakistan, where maternal health remains a major public health concern, a growing body of evidence suggests that the roots of this crisis often begin long before a woman reaches the delivery room.
For decades, global efforts to reduce maternal mortality have understandably focused on emergencies during childbirth, particularly postpartum haemorrhage, a severe form of bleeding after delivery that remains one of the leading causes of maternal deaths worldwide. Improving emergency obstetric services, ensuring skilled birth attendance and strengthening hospitals have saved countless lives. Yet new research has drawn attention to another silent threat that has remained underestimated: anaemia among pregnant women.
A major international study involving more than 15,000 women, including over 11,000 participants from Pakistan, has revealed the devastating impact of maternal anaemia on survival during childbirth. The findings carry particular significance for Pakistan, where researchers estimate that a large majority of pregnant women may be affected by the condition. Anaemia is often viewed as a routine health problem, something that causes tiredness or weakness, but its consequences can be far more severe. A woman whose body is already struggling to carry enough oxygen through the bloodstream enters pregnancy and childbirth with a reduced ability to withstand even normal complications.
The study highlights a worrying reality: women suffering from moderate or severe anaemia face significantly higher risks during childbirth. Blood loss that a healthy mother may survive can become life-threatening for someone whose body lacks sufficient reserves. Severe anaemia can lead to shock, organ failure and death, turning what should be a moment of celebration into a preventable tragedy. The impact also reaches beyond mothers. A mother’s health is closely connected to the survival and wellbeing of her child. Anaemia during pregnancy increases the likelihood of premature birth, low birth weight, stillbirth and newborn deaths.
Among women suffering from severe anaemia, the reported stillbirth rate reflects the seriousness of the crisis. These figures demonstrate that maternal health is not only a matter of protecting women but also a foundation for the health and future of the next generation. The persistence of anaemia in Pakistan is not simply a medical challenge; it is a reflection of wider social and economic inequalities. Poverty remains one of the strongest drivers of poor maternal nutrition. For many families, access to iron-rich foods, fresh vegetables, proteins and essential nutrients remains limited.
In households facing financial hardship, women frequently compromise their own nutrition, often eating after other family members and receiving less nutritious portions. Poor sanitation and unsafe drinking water add another layer to the problem. Repeated infections, intestinal parasites and waterborne illnesses can weaken the body and reduce its ability to absorb essential nutrients. Closely spaced pregnancies further increase the risks by exhausting women’s nutritional reserves before their bodies have recovered from previous childbirths. Another challenge is that anaemia often remains invisible because its symptoms have become normalized.
Many women live with constant fatigue, dizziness, weakness and shortness of breath without recognizing these signs as indicators of a serious health condition. In many communities, such struggles are accepted as an unavoidable part of a woman’s life rather than a warning that medical attention is needed. Limited access to healthcare facilities, particularly in rural and marginalized areas, allows the problem to continue unnoticed. This situation demands a broader understanding of maternal healthcare. Protecting women cannot begin only when labor starts.
A successful strategy must follow a woman’s entire life journey, beginning with adolescent health, continuing through reproductive years and providing consistent support during pregnancy. Anaemia screening should become a routine part of primary healthcare. Women should have access to testing before pregnancy and throughout the antenatal period so that problems can be identified and treated early. Iron and folic acid supplementation programs must also be expanded, with stronger efforts to ensure that women receive supplements regularly and understand their importance.
Healthcare workers and community-based programs can play a decisive role in reaching women who remain outside formal healthcare systems. They can identify vulnerable mothers, encourage antenatal visits and provide guidance on nutrition and prevention. However, medical solutions alone will not be enough. Tackling anaemia also requires addressing food insecurity, improving sanitation and empowering women with knowledge about their own health. Education has an important role in breaking the cycle. Teaching adolescent girls about nutrition and reproductive health can prevent anaemia before pregnancy begins.
Public awareness campaigns can challenge the belief that weakness and exhaustion are simply part of being a woman and encourage families to treat maternal nutrition as a priority. Pakistan’s maternal health crisis requires sustained political commitment and long-term investment. Government institutions, healthcare providers and development partners must recognize maternal anaemia as a national priority rather than a secondary concern. Better healthcare infrastructure, stronger data systems and targeted programs in high-risk communities can prevent thousands of avoidable deaths.
(The writer is a social development professional. He can be reached at editorial@metro-morning.com)
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