Rising Maternal Mortality and Systemic Challenges in Rural Pakistan: A Retrospective Analysis of Primigravida Deliveries

Background: The Buner District, Khyber Pakhtunkhwa, Pakistan, has a structurally limited maternal and fetal health outcome CDC rural healthcare setting. The Annex Paper collected in his study provides detailed outcomes of primigravida maternal and fetal outcomes at DHQ Hospital Daggar for Two years (2023-2024).Background High maternal mortality, fetal death rates, Left Against Medical Advice (LAMA) cases, and referral patterns had led to this research focusing on first-time mothers aged 14 to 27. With the aim of offering tangible implications for enhancing maternal and neonatal health systems in the area. Method: This study is a retrospective observational study based on the hospital records of DHQ Hospital Daggar for a duration of 2023 and 2024. The data set was restricted to those aged 14–27 years undergoing a first-time delivery with complete medical records. Infographics were generated on Microsoft excel and SPSS for Descriptive statistics and chi-square tests to identify any significant trends. Results: It looked at 2,743 deliveries in 2023 and 3,021 in 2024. Maternal deaths rose from 142 to 164 over this period, while fetal deaths were unchanged at 44 a year. Cases of LAMA increased from 234 to 263, indicating an ongoing patient retention challenge. Finally, the number of referral cases increased from 146 in 2023 to 159 in 2024, reflecting the increasing stress on the healthcare system due to the lack of resources and capability to treat complicated cases. Conclusion:This emphasizes the urgent need for wide-ranging reforms in maternal care provision, in the face of escalating maternal death, increased late arrival in medical care, and escalation in referrals. Improving early pregnancy care, patient education, and strengthening referral systems to achieve better maternal and neonatal health care outcomes would address these challenges.