Global Commitment to Safe Motherhood


Here in the United States, it seems like Mother's Day is getting ever more commercialized. Each year, the Mother's Day cards go on display earlier and the exhortations to celebrate mom with flowers and brunch seem more plentiful. Already, emails about how to honor our mothers with flowers and gifts, or by making donations to worthy causes, are starting to arrive in our in-boxes.

Mother's Day is bittersweet for those of us who work in the field of maternal health. On the one hand, we appreciate the earnest tributes to the importance of mothers. And it is gratifying to note the increased global focus on the preventable tragedy of women's pregnancy-related deaths: Nicholas Kristof writes heartbreaking stories about women's lives and deaths in developing countries; maternal health is now enshrined in the Millennium Development Goals; and NGOs and donors alike—notably Britain's Department for International Development (DfID)—are making significant commitments to combat maternal deaths.

On the other hand, the reality is still that pregnancy is terribly dangerous for women around the world. The fact that the numbers are so familiar to us—one in 16 women in developing countries still dies from a pregnancy-related cause—in no way lessens their horror.

Over 20 years ago, I was in Nairobi attending the conference marking the end of the UN Decade for Women for the Carnegie Corporation. A World Health Organization (WHO) spokesperson told us that new figures indicated that a woman dies every minute from pregnancy. I was shocked by this fact, by the injustice that it represented, and I resolved at that moment to do something about it. Family Care International (FCI), the organization I founded with my colleague Ann Starrs, grew out of our conviction that we needed to start focusing the world's attention on these unnecessary deaths, and developing strategies to combat this problem. The founding of FCI coincided with the launching of the Safe Motherhood Initiative; FCI served as the Secretariat of this effort for 17 years, until its expansion into The Partnership for Maternal, Newborn, and Child Health, now housed at WHO.

This year, FCI—and the Safe Motherhood Initiative—are celebrating their 20th Anniversaries. Despite 20 years of effort, we know that one in 16 women in developing countries still dies from pregnancy. The contrast with our own lives is painful. When I ride on a crowded subway in New York, I look at the women around me and estimate that if they lived in rural Africa, two, three, or more of them would die prematurely and painfully simply because they live in a place without access to care. Each death must mean so much to these women's children, parents, partners, and communities. Last fall, when I visited communities in rural Kenya where FCI implemented our Skilled Care Initiative, I met women who told me their health and their lives were saved by improved health care services. Why are women still dying to give birth? And, most importantly, what can we do?

We've learned a lot over the past 20 years. The evidence is now clear—a midwife or doctor, with proper training and the right environment (which includes basic equipment, infrastructure, supervision, and policies) can manage many of the complications that arise before, during, and after childbirth. When the health care system is strengthened and women use it, we have seen dramatic reductions in maternal deaths, even in relatively poor countries.

But, there are far too many settings around the world where women—particularly those who are poor, indigenous, and rural—cannot access the high quality care that can save their lives.

We know what we need to do; we need the funding and political support to do it. Clearly, women's lives have to matter—not just to their partners and their children, but to their communities' leaders, their politicians, their religious leaders. We need to advocate for these critical investments on multiple levels, using arguments that resonate with different audiences. Safe motherhood is a rights and equity issue and we need to focus on it as such. The economic argument—that countries simply cannot afford to lose so many young, productive people—is also very powerful with important decision-makers, including finance and planning ministers, and corporations.

To mark 20 years of the safe motherhood movement, and to provide direction and momentum for the next 20 years, FCI is serving as the organizing partner for a major conference. Women Deliver, which will take place in London in October, will bring together political leaders, parliamentarians, business leaders, technical experts, and other leaders to mobilize increased investment and commitment to maternal health. We know that the health sector alone cannot solve the complex problem of maternal deaths, so these experts and creative thinkers will come from a range of sectors: maternal health, and also human rights, gender, HIV and AIDS, education, micro-enterprise, sexual and reproductive health, including family planning, and more. (More information is available on the Women Deliver website.)

This Mother's Day it is time to make good on our promises, not just to our own mothers, but to the mothers of the world.

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