Birth and mortality
For the most part, women die in childbirth unnecessarily Photo: blink
As we pause to celebrate female achievements on International Women’s Day each year, one question – albeit a mood dampener – tends to spring to mind. Despite the astounding medical progress in the past decade, why does childbirth remain the biggest killer of women of childbearing age?
According to the United Nations (UN), 1,000 women die each day due to pregnancy related causes. Most of these occur in the developing world. In fact, the risk of a woman dying from maternal health complications is a whopping 36 times higher in a developing nation than a developed one.
Granted, the world has seen some improvements in the realm of maternal health, but the impact has not been felt everywhere. According to the UN, the number of women dying due to complications during pregnancy and childbirth has decreased by 34 per cent from an estimated 546,000 in 1990 to 358,000 in 2008.
The reduction in maternal mortality is welcome and certainly notable, but the annual rate of decline is still less than half of what is needed to achieve the Millennium Development Goal (MDG) target of reducing the maternal mortality rate by 75 per cent by 2015.
For the most part, women die in childbirth unnecessarily. WHO says the main causes of maternal death are severe bleeding, infections, unsafe abortions, eclampsia and obstructed labours.
Life-saving work is being performed every day to combat these problems. Maternal health advocacy group Women Deliver just issued their annual compilation of the 50 most inspiring ideas and solutions for improving maternal health.
Incidentally, Australia’s own Dr Catherine Hamlin AC was included on the list for her work in repairing obstetric fistulas, which are holes that develop between the rectum or bladder and vagina after severe childbirth leading to the constant leaking of urine and faeces, which immediately stigmatises women if not treated.
And the list of inspiring, heroic work is growing. From the most basic of interventions, such as the collation of simple hygienic supplies by the Birthing Kit Foundation; to longer term strategies such as the Australian Government’s funding of a program in Papua New Guinea to increase the number of midwives; to the ongoing work of Médecins Sans Frontières (MSF) in emergency zones where 60 per cent of surgical procedures are obstetric interventions and C-Sections.
You could be forgiven for thinking the issue is a matter of logistics and an increase in medical supplies. But as MSF’s Medical Advisor for Women’s Health, Kara Blackburn explains, “It’s never a single strategy that will combat this devastating problem. Just because you set up an emergency unit, some women still might not be able to get access to using it.”
See, despite ongoing medical and logistical challenges, all advocates agree on a deeper systemic issue that will continue to impede progress: gender inequality. In his best-selling book, Half the Sky, New York Times columnist Nick Kristof quotes from the journal Clinic Obstetrics and Gynecology: “Women are not dying because of untreatable diseases. They are dying because societies have yet to make the decision that their lives are worth saving.”
Lesley Barclay, awarded an Order of Australia in 2004 in recognition of her contribution to international development and child health, calls for more public support on the issues of maternal health.
“Women and children’s health is not high tech. It’s not glamorous. Areas such as HIV, and swine flu and the like seem to capture the public attention and certainly attract more funds and more activity. Maternal and child health is about hard graft at the coalface. Developing systems in poor villages with struggling health services to keep women and children safe – that’s difficult stuff.”
Dimity Fifer, president of Safe Motherhood for All (a new umbrella organisation that’s part of the global White Ribbon Alliance), insists that the world needs a grassroots movement to advocate for mothers everywhere. “The slow rate of improvement in maternal health is part of a broader struggle for women’s rights in general. A focus on maternal health must be part of a bigger movement to champion the rights of women at every level of society.”
It is with that sentiment that today’s debates and celebrations present the perfect opportunity to include a conversation about the most unnecessary form of suffering women face today.
- 94 per cent of women in Ethiopia and 62 per cent of women in Papua New Guinea give birth without trained professional care
- Mortality rate in child birth is 1 in 11 in Afghanistan; 1 in 14 in Somalia and 1 in 7,400 in Australia
- In Sub-Saharan Africa, parts of Asia and Latin America, girls are often married and bear their first child before the age of 16
- Women younger than 15 years of age are five times as likely to die from childbirth, and twice as high between the ages of 15-19, than women in their 20s
- In Guinea, Africa, women have to foot 89 percent of their own health care bills, plunging them further into poverty
- WHO says of the 1,000 women who die in childbirth each day, 570 are from sub-Saharan Africa, 300 are from South Asia, while just five come from in high-income countries
- Under Taliban rule, many Afghan women are afraid to leave the house to access medical assistance
Julie Ulbricht is a freelance writer and one of the founders of Send Hope Not Flowers www.sendhope.org. She tweets at @Julie_Ulbricht