Global Commitment to Safe Motherhood

If the Women Deliver conference in London last week was an advocacy campaign, then it seems to have worked.

Ministers of Health and Finance turned up. They made a powerful declaration of support, and concrete suggestions for how to improve the status of maternal health on the international development agenda. Reproductive and maternal health organizations and agencies used the conference to invite other sectors to comment on their work – sometimes critically. And a lot of questions were asked about why 20 years after its launch, the Safe Motherhood Initiative (SMI) is not meeting its targets.

Although these targets have not been met, attitudes have changed. Fred Sai, who chaired the 1987 Safe Motherhood Conference, dismisses any concept that maternal health is a local, cultural issue that should not be tampered with. “There is only one culture that we need to look at. The culture of delay that maintains the terrible difference between rates of maternal mortality in the North and in the South,” he says. A Nigerian conference delegate agrees with him. “We don’t have time to stop and theorize about cultural influences. We see the problem every day, in women’s homes, on their doorsteps. We just need to get on with it.”

Others brought further realism to the conference. On the final day of the conference, The Norwegian Government announced a new financial commitment to Millennium Development Goals 4 and 5, with the proviso that resources will only be awarded to those organizations that can prove their effectiveness at local levels. Mia Faikenberg, a Danish parliamentarian who attended the Women Deliver Ministers’ Forum, said she had enjoyed the “big passion” and the creativity at the conference. “As a parliamentarian a lot of people are asking me about increased funding. It is a good agenda. I understand why it needs to be supported. But I want to know how effectively our existing funding is being spent. The real money should only go to those who are doing the real work.” IPPF Secretary General Gill Greer agrees, "Today, no-one has an automatic right to funding. We need to prove we are making a difference.”

In Malawi, a huge difference has been made in the fight against maternal mortality, thanks – in no small part – to the determination and vision of its Minister of Health Marjorie Ngaunje. “In my country we have a Road Map to reduce maternal mortality that is fully integrated into the health SWAp,” she explains. “We want pregnancy to become a cause for celebration not a death sentence in Africa. We know what we want, and we are using the development aid structures to make it happen.”

The expectations were high for this conference, but the organizers were optimistic about the outcome. Executive Vice President of Family Care International (FCI) Ann Starrs says “Women Deliver has put maternal mortality on the global agenda in a way that it cannot be ignored.” FCI’s President Jill Sheffield agrees. “This conference got people really thinking about what women deliver to the world. It has articulated the place of women in the broad context of development. And it has opened the doors to new partners outside the health sector.” What does she expect at the 40th Anniversary of the Safe Motherhood Initiative? “We need to meet a lot sooner than then. We need to keep this agenda visible and strong.”

The UK Department For International Development pledged £100 million to UNFPA on the first morning of the conference. The Japanese Government sent a message to the conference announcing its intention to place global health at the centre of next year’s G8 summit in Japan. And The MacArthur Foundation pledged US $11 million to reducing maternal mortality in Nigeria and India.

On the first afternoon of the conference Sudanese midwife Awatif Altayib Mohamad Hussein addressed the plenary for three minutes. Awatif has travelled for up to 10 hours a day on a donkey to reach rural communities where women – as she did once – suffer from obstetric fistula. I asked her what her message to Women Deliver would be. “The US and others need to give more money so I can continue my work,” she says.

Whether or not Awatif gets more money for her work is beyond her control. It is not beyond the control of many others who attended Women Deliver. And to make the next 20 years a success rather than a further failure, some of the candour and pragmatism and good will shown at Women Deliver needs to be disseminated further afield – and the issues translated into a language that those who do not as yet understand the importance of the women deliver agenda will comprehend.

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    Letter to the Organizing Committee of the Conference “Women Deliver”

    London, 20 October 2007


    Jill Sheffield, President, Family Care International and the Organizing Committee

    CC: Dr. Asha-Rose Migiro, Deputy Secretary-General of the United Nations and Conference Honorary Co-Chair

    CC: Hon. Mary Robinson, President of Realizing Rights and Conference Honorary Co-Chair

    WE, THE UNDERSIGNED ORGANIZATIONS, wish to express our profound disappointment and dismay that the Women Deliver conference has failed to meet its stated objective of addressing Millennium Development Goal 5, which is to reduce maternal mortality and morbidity.

    Delegates were invited to attend a global conference on the causes, prevention and treatment of the complications of pregnancy and childbirth which lead to the deaths of so many mothers, particularly in developing countries, and to consider effective solutions.

    Regrettably, the conference agenda was so preoccupied with promoting the ideology and practice of abortion that the genuine healthcare needs of women and children were virtually ignored in the plenary sessions and overwhelmed in the panel discussions.

    Numerous UN reports, such as The World’s Women 2005: Progress in Statistics, have concluded that accurate data about maternal mortality, including abortion, are not available, especially for the developing world. Therefore, the presentation of unsubstantiated and unreliable data on illegal abortion as fact can only be seen as a deliberate attempt to mislead the conferees and the international community.

    To assert that “unsafe abortions” are only those that are illegal, and to subsequently imply that legal abortion is therefore safe, is both disingenuous and scientifically flawed. The fact that the World Health Organization (WHO) will not be collecting information on the morbidity and mortality related to legal abortion is unconscionable if there is truly a commitment to accurate and meaningful data collection on morbidity and mortality statistics.

    The consistent assertions that improvements in the maternal mortality rate are dependent on the promotion of legal abortion not only diverts attention from the urgent need for basic heath care, skilled birth attendants and emergency obstetrics, it threatens to undermine the field of obstetrics and gynecology if implemented on a wide scale.

    Furthermore, we oppose the fact that:

    – Members of the organizing committee, including the International Planned Parenthood Federation (IPPF) and Marie Stopes International, who have financial interests in the provision of abortion, have used the conference to promote a private agenda to spread abortion throughout the developing world;

    – The organizing committee has attempted to manufacture a false consensus by ensuring that only the views which reinforced its pre-conceived ideas were represented during the conference;

    – The conference has sidelined the main issues related to maternal mortality (basic health conditions based on vaccine availability, clean water, sanitation, basic nutritional supplementation, primary medical post-natal and peri-natal care, fistula, female genital mutilation, hemorrhage, sepsis, obstructed labor, eclampsia). Such sidelining is a serious act of negligence which leads not only to continuing, but increasing, the risks associated with maternal health.

    We call upon the conference partners to focus on basic health care, skilled attendants and emergency obstetrics, which have been the key to decreasing maternal mortality in the developed world, instead of exploiting the tragedy of maternal mortality to promote abortion rights.

    • Instituto De Política Familiar (IPF), ECOSOC consultative status with the UN
    • Concerned Women for America (CWA), ECOSOC consultative status with the UN
    • MaterCare International (MCI), ECOSOC consultative status with the UN
    • World Federation of Catholic Medical Associations (FIAMC), ECOSOC consultative status with the UN
    • United Families International (UFI), ECOSOC consultative status with the UN
    • Society For the Protection of Unborn Children (SPUC), ECOSOC consultative status with the UN
    • World Union of Catholic Women’s Organisations (WUCWO), ECOSOC consultative status with the UN
    • Federación Española de Asociaciones Provida, ECOSOC consultative status with the UN
    • Catholic Family and Human Rights Institute (C-FAM)
    • American Association of Prolife Obstetricians and Gynecologists (AAPLOG)
    • Instituto Mujer y Vida, Spain
    • Comité Nacional Provida de México, A.C.
    • Salud Sexual y Reproductiva De México, A.C.
    • Asociación Mexicana “Cultura de la Vida

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    I attended the conference as well and I find it very surprising if not absurd that you claim that

    “the conference agenda was so preoccupied with promoting the ideology and practice of abortion that the genuine healthcare needs of women and children were virtually ignored in the plenary sessions and overwhelmed in the panel discussions”.

    I attended all the plenaries and many of the parallel seminars and although abortion was mentioned at times, it was by no means dominating the agenda.

    I wonder how you got this impression?

    Sabine (PhD student)

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    One of the premier organizations supporting Women Deliver was the United Nations Population Fund which is not involved in abortion but with its family planning emphasis prevents millions of abortions each year. I saw a BBC produced film called Dead Mums Don’t Cry at the conference and basically saw a 12 year old girl die from an abortion. Safe motherhood and family planning were the overwhelming themes of the conference. When the Bush Administration refused to release $34 million to UNFPA in 2002 Lois Abraham and I started asking 34 million Americans to send at least one dollar. One hundred eighty countries supported UNFPA last year, but not MY USA. For shame!

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    Women Deliver was all about setting the agenda to promote worldwide abortion on demand. The sponsoring organizations all have a vested interest in earning windfall profits from luring women into abortion. These organizations are far more concerned about deproductive “rights” than reproductive rights. Furthermore, the conference spewed hatred for people of religious faith. There was little tolerance expressed. Finally, Lesley Barned makes a ludicrous statement in claiming that women’s issues cannot be discussed without bringing up abortion. This just furthers the groups’ accurate claims that the whole focus was on abortion.