Mothers in sub-Saharan Africa are 50 times more likely to die after cesarean sections than in high-income countries, according to new research.

The study on maternal and neonatal outcomes post C-section delivery in Africa was conducted by a group of researcher and published in the Lancet’s April 2019 volume. It revealed that for every 1,000 women, 5.43 women died after having a C-section across the 22 African countries that were part of the study. In comparison, there are 0.1 deaths per 1,000 in the UK, according to the Telegraph.

These deaths are the result of poor access to health care and are caused by a variety of issues: perioperative bleeding, surgery complications such as a post-partum haemorrhage, severe obstetric haemorrhages, or anaesthesia complications, the report states.

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Every day around the world, more than 800 women die due to preventable pregnancy and childbirth complications — 99% of all maternal deaths occur in developing countries, two-thirds of which are in sub-Saharan Africa, according to the World Health Organization (WHO).

This research emphasize the need for improved access to safe C-sections and outlined how this could lead to better global health outcomes overall.

The study’s lead author, Bruce Biccard, said that this report suggests that access to maternal health care in Africa is very sparse.

“The result is that because of that, mothers are presenting late with a lot of problems and the outcomes are terrible,” Biccard told Global Citizen.

Biccard said that three-quarters of all C-sections in sub-Saharan Africa are emergency surgeries.

“It illustrates how much we need to do [in] increasing access to surgery,” he said.

He points out that increasing the number of planned C-sections could result in a lower mortality rate, as complications and risks could be tracked beforehand, which means the surgeries would be planned and safe, as opposed to emergency and potentially deadly situations.

His team didn’t track the reasons why the surgeries were so often classed as emergencies, but he assumes it is likely a number of things — distances to health centres, mothers being unable to seek care early on, and a lack of antenatal care especially.

It’s globally accepted that there should be about 20 cesarean specialists per 100,000 births, Biccard says. Throughout Africa, he said there’s generally fewer than 1 per 100,000.

“We need more human resources, definitely,” he said. “We need more training, where we really need to focus is identifying the mothers who are going to bleed — how do we manage the mothers that are going to bleed.”

Biccard calls the current situation a “bad societal story.” He believes that so much of the cycle — maternal, neonatal, and early childhood mortality rates — stems from the fact that high-risk mothers presented too late and that resulted in risky C-sections.

“The message that needs to get out is just [that] we don’t have enough resources.” he said.

Biccard says that raising awareness is an important step in gaining support on an international level, and he hopes that support will eventually equate to funding for initiatives to help improve maternal health across Africa.