Maternal Health: Moving Forward or Backward?


This is the last in a series of posts about maternal mortality written by Jill Sheffield leading up to the Women Deliver Conference, October 18-20th, in London. RH Reality Check will be covering the conference, with reports from our Global Perspective writer in England, Rupert Walder, as well as from youth attendees from Advocates for Youth. Also, stay tuned for Jill Sheffield's post-conference analysis at the end of October!

The Women Deliver conference is only a couple of weeks away, and momentum is building. We've seen a flurry of activity that shows our message is registering with world leaders: Invest in women-it pays!

Over the past couple of months, more headlines have appeared on maternal and child mortality than during most of the past year.

In late August, the Centers for Disease Control released the newest statistics on U.S. maternal mortality: Things are getting worse.

According to the CDC's August 21 National Vital Statistics Report, complications of pregnancy and childbirth killed 540 U.S. women in 2004. That's 45 more than in 2003, the highest total since 1977. And for every woman who dies, another 30 suffer long-term illness or disability.

The scandalous U.S. maternal death rate is now 13.1 deaths for every 100,000 live births, among the highest rates for any industrialized country. Translated into the lifetime risk for women of childbearing age, this means one in 2,500 American women will die from pregnancy-related complications. That puts the United States at number 36 in the world rankings of 181 countries, behind Poland and Korea and just ahead of Bulgaria.

The reasons: rising U.S. rates of obesity, diabetes and high blood pressure, along with better reporting. Poor health care for minority U.S. women is the underlying problem: the rate for black women is nearly four times that for white women – 34.7 deaths per 100,000 live births versus 9.3.

Then UNICEF released figures showing child deaths at a record low of 9.7 million per year -below 10 million for the first time since records have been kept. The level is still tragically high, and it's not coming down as fast as it did in the 1970s, but it shows what can happen when donor priorities target one area.

It's time to target maternal mortality. A recent Newsweek article points out the obvious: the cures are well known and cost-effective. They are: education for girls and women, to teach them about their bodies and give them options in life beyond childbearing; better access to comprehensive reproductive health services, including family planning and abortion-related services; skilled care during pregnancy and delivery; and access to emergency services.

That's the idea behind two new European initiatives to save women and children. Last month, British Prime Minister Gordon Brown and Germany's Chancellor Angela Merkel detailed the International Health Partnership (IHP), a major multi-government initiative to strengthen developing countries' health care systems to fight disease and reduce child and maternal mortality.

Then, Norway led a coalition of governments announcing a major advocacy drive called Deliver Now for Women and Children. That drive joined the IHP as one of several parts of a broader Global Campaign for the Health MDGs. Norway then pledged an additional $1 billion specifically for MDGs 4 (reduce child mortality) and 5 (improve maternal health). A glittering event launched Deliver Now in New York City to build momentum for all these efforts worldwide.

This welcome activity is perfectly timed to coincide with Women Deliver, the Oct. 18-20 conference of more than 1,500 world leaders at London's ExCel Centre. The World Bank will join the chorus at its annual meeting in Washington with a special Oct. 18 session on Women Deliver issues. The Lancet will devote its Oct. 13 edition to Women Deliver, and WHO, UNFPA and UNICEF will make public new maternal mortality statistics and country rankings for 2005, the latest in their series of five-year updates.

In short, Women Deliver is already helping to generate serious political will worldwide to save the lives and improve the health of women, mothers and newborn babies around the world. We expect the gathering to be a landmark moment as we join to make history on this stubborn issue. After all, we're halfway to 2015, the target for achieving the Millennium Development Goals – and this activity gives me hope we might actually get there.

It's time to deliver for women.

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  • invalid-0

    I really think that all the interventions have to factor in to the US maternal mortality rate increase. Cesareans increase the risk of death for both mother and baby. Inductions and epidurals are NOT safe yet most women seem to be getting one or the other, usually both.
    Birth is inherently safe…meddling with it is RISKY.
    Carla Hartley
    http://www.ancientartmidwifery.com
    http://www.birthtruth.blogspot.com
    http://www.trustbirth.com
    http://www.trustbirthconference.com

  • invalid-0

    Carla
    I think you’re being a little disingenuous here. Birth is not always inherently safe, with or without “meddling” and never has been. Especially in most of the developing world. A malnourished illiterate 14 year old, who is possibly not yet fully grown herself, probably forced into an arranged marriage, working like a donkey up til she goes into labor, laboring in agony 3 or 4 days and then losing her baby and ending up with a fistula, would probably welcome all the ‘meddling’ the medical world has to offer.

    But I agree the US should be ashamed of its infant mortality rates. In a country this wealthy it’s more a political issue than a medical one. We have the resources, it’s a distribution problem.

    • invalid-0

      Isabelle,

      Really, Carla is “disingenuous” for stating fact? I really don’t think the malnourished 14 year old with fistula is the woman Carla is calling to action, to “own” her birth! For the sake of truth we need to speak of the normal, healthy mothers (90% at least in the US), not the exceptions!!! This is much more than a “distribution” problem. I would do better to do your own research and study before calling names…