The burden of maternal ill-health includes not only the levels of
maternal mortality and complications during pregnancy and around the
time of delivery but also extends to the standard postpartum period of
42 days with consequences of obstetric complications and poor
management at delivery. There is a dearth of reliable data on these
postpartum maternal morbidities and disabilities in developing
countries, and more research is warranted to investigate these and
further strengthen the existing safe motherhood programmes to respond
to these conditions. This study aims at identifying the consequences of
pregnancy and delivery in the postpartum period, their association with
acute obstetric complications, the sociodemographic characteristics of
women, mode and place of delivery, nutritional status of the mother,
and outcomes of birth. From among women who delivered between 2007 and
2008 in the icddr,b service area in Matlab, we prospectively recruited
all women identified with complicated births (n=295); a perinatal
mortality (n=182); and caesarean-section delivery without any maternal
indication (n=147). A random sample of 538 women with uncomplicated
births, who delivered at home or in a facility, was taken as the
control. All subjects were clinically examined at 6-9 weeks for
postpartum morbidities and disabilities. Postpartum women who had
suffered obstetric complications during birth and delivered in a
hospital were more likely to suffer from hypertension [adjusted odds
ratio (AOR)=3.44; 95% confidence interval (CI)=1.14-10.36],
haemorrhoids (AOR=1.73; 95% CI=1.11-3.09), and moderate to severe
anaemia (AOR=7.11; 95% CI=2.03- 4.88) than women with uncomplicated
normal deliveries. Yet, women who had complicated births were less
likely to have perineal tears (AOR=0.05; 95% CI=0.02-0.14) and genital
prolapse (AOR=0.22; 95% CI=0.06-0.76) than those with uncomplicated
normal deliveries. Genital infections were more common amongst women
experiencing a perinatal death than those with uncomplicated normal
births (AOR=1.92; 95% CI=1.18-3.14). Perineal tears were significantly
higher (AOR=3.53; 95% CI=2.32-5.37) among those who had delivery at
home than those giving birth in a hospital. Any woman may suffer a
postpartum morbidity or disability. The increased likelihood of having
hypertension, haemorrhoids, or anaemia among women with obstetric
complications at birth needs specific intervention. A higher quality of
maternal healthcare services generally might alleviate the suffering
from perineal tears and prolapse amongst those with a normal
uncomplicated delivery