Pregnant women in homes without piped water and proper toilets face significantly higher risk of deadly pregnancy complications, a major study in The Gambia has revealed.
The research, published in PLOS Global Public Health, tracked 5,745 pregnant women in The Gambia, Kenya and Mozambique under the PRECISE cohort unlike hospital-based studies, focused on ordinary communities.
According to the study, women relying on public taps or protected wells classified as other improved sources had an 18% higher risk of placenta-related complications compared to those with water piped into their compound.
“Those using unprotected wells and surface water had a 23% higher risk,” it stated.
Unimproved sanitation, the study added, is equally dangerous, adding that women using unimproved toilets faced a 15% higher risk.
The complications measured pre-eclampsia, babies born too small, and stillbirth all stem from placental failure.
“When the placenta fails to develop proper blood vessels, the mother suffers hypertension and organ damage, while the fetus is starved of oxygen and nutrients.”
Researchers, led by Joseph Wells, say the link is not just about access, but what happens after.
“Even clean water from a public tap can be contaminated during collection, transport and storage. The daily burden of hauling water also puts severe physical stress on pregnant women. The direct pathway is infection.”
The study further added that poor sanitation exposes mothers to fecal pathogens, triggering chronic inflammation that disrupts placental development.
“The implication is clear: maternal death in The Gambia is not only a clinical problem. It is a water and sanitation problem.”
The authors argue that extending piped water, improving household storage, and expanding improved toilets could be a powerful, low-cost strategy to cut maternal and newborn deaths.
