San Jose Mercury News
Friday October 19, 2007
Money and political will can save women from dying in childbirth
By Kate Grant
Article Launched: 10/19/2007 01:31:25 AM PDT
Every 24 hours, 1,500 women die due to pregnancy and childbirth. That is the equivalent of the downing of five jumbo-jets filled with pregnant or laboring women, and it is the same every day of every year in recent decades, totaling approximately 535,000 deaths per year.
If you just read that statistic and thought, "That can't be true," I urge you to think again, but not of the women you know in this country who, like me, take a safe delivery for granted. Rather, think of the billions of women who live in developing countries, for this is where 99 percent of these deaths occur.
Most women I know enter pregnancy with a great sense of anticipation. And while first-time mothers here may wonder how motherhood will change their lives, very few worry that pregnancy and childbirth might end their lives. The same is not true for women of reproductive age in developing nations. For them, pregnancy and childbirth are still the leading causes of death and disease. According to the World Health Organization, a woman living in sub-Saharan Africa faces a lifetime risk of dying due to pregnancy of 1 in 16; an American woman's lifetime risk is less than 1 in 2,500. This is the largest rich-poor disparity among all the public health indicators tracked by WHO. For me, the most shocking thing about these statistics is that they have changed relatively little in the past two decades - a period during which we've witnessed draamatic improvements in other health indicators in developing countries, such as child survival.
Today in London, public health experts, political leaders, activists, academics and physicians from around the world are attending a conference called Women Deliver. Their main goal is to create the political will necessary to save the lives of women around the world. For those of us attending, the clear first step in creating that political will is raising widespread awareness of the tragic deaths of women that happen every minute of every day and underscoring the policies and investments that can help save lives.
If you think for a moment about what helps create a safe delivery in this country, you will understand what's missing in developing countries. In the United States, couples have ready access to family planning education and products, and, for those with insurance, prenatal care is available. Whether insured or not, women have access to emergency obstetric care to help ensure a safe delivery even when there are complications. In many parts of the developing world, access to family planning, prenatal care and emergency obstetric care is uneven at best, and too often is unavailable.
The Women Deliver Conference will focus attention on three key practical solutions that can help save women's lives:
First, provide access to comprehensive reproductive health services. There are more than 200 million women with an unmet need for effective contraception. An estimated 90 percent of deaths from unsafe abortions and 20 percent of obstetric deaths could be averted by access to birth control.
Second, provide equal access to education for women and girls. Female education is strongly correlated with healthier women, healthier children and higher household income. It is important, too, that women and girls have life options beyond childbearing. Education is positively associated with delayed childbearing, which can improve birth outcomes; girls under 15 die in childbirth five times more often than women in their 20s.
Third, provide access to skilled midwives, nurses and doctors. Many of the women who die during labor do so in hospitals, but often they arrive too late to be saved or the hospital is ill-equipped to save them. There is a shortage of trained medical personnel at the village, city, regional and national level in most developing countries. Indeed, on a global scale there is a shortage of 4 million health workers that is most severe in rural areas of developing countries.
Unlike some diseases for which we still are in search of a cure, we know what can save the lives of mothers and would-be mothers - access to birth control, the ability to make wise choices about their reproductive lives and access to medical assistance to make safe pregnancy and delivery possible. All that is needed is the political will and financial investments to make these policies a global reality.
KATE GRANT is the executive director of the Fistula Foundation and former deputy chief of staff at the U.S. Agency for International Development (1995-97). She wrote this article for the Mercury News.
http://www.mercurynews.com/search/ci_7222055?source=email