POPULATION-WOMEN: Motherhood Still Not Safe, UN Warns

By Farhan Haq Reprint | | Print |

UNITED NATIONS, Apr 7 1998 (IPS) - More than 1,600 women die each day as a result of complications from pregnancy or childbirth, although their deaths could be prevented by health services at an annual cost of as little as two dollars per person, according to the United Nations.

Three U.N. agencies – the U.N. Population Fund (UNFPA), U.N. Children’s Fund (UNICEF) and World Health Organisation (WHO) – added that, in addition to roughly 600,000 fatalities, some 50 million women suffer injuries every year from pregnancy or childbirth. The three U.N. bodies joined with population groups and governments Tuesday to condemn the heavy toll and to seek solutions.

“Now is the time to act upon what has been learned over the past 10 years of research and model projects, before one more woman’s life is lost needlessly,” said Jill Sheffield, president of Family Care International, which chairs an inter-agency group on safe motherhood comprising the U.N. and non-governmental organisations.

As much as one-quarter of all maternal deaths stem from severe bleeding, often linked to the delivery itself. Infections account for 15 percent of the fatalities, while unsafe abortions (13 percent), eclampsia (12 percent) and obstructed labour (8 percent) are also among the most common causes of death.

WHO argues that most maternal deaths occur during or shortly after childbirth, and stem from lack of access to basic medical care. Only 53 percent of deliveries in developing countries are assisted by either a doctor or midwife, even though such assistance could ensure that conditions for delivery will be hygienic and that complications can be managed efficiently.

A full programme to prevent maternal deaths – as well as those of at least 1.5 million children annually – would require the presence of a skilled attendant at all deliveries; treatment of complications; and postpartum family planning and neonatal care, WHO says. In low-income countries, the cost of such programmes would amount to three dollars per person per year – and only two dollars for maternal health services alone.

“Simple measures ensuring safe motherhood would also eliminate untold amounts of suffering throughout the world,” argued Sheffield.

Some of the efforts to provide simple maternal services can be difficult, however – as UNICEF has learned in Afghanistan, which has the highest maternal mortality rate among all countries.

UNICEF Executive Director Carol Bellamy said Monday following a visit to Taliban-held parts of Afghanistan that her agency would continue to try to provide assistance there, but she added that the Islamist leaders of the Taliban made that task complex by placing restrictions on access to women.

UNICEF, in a statement, argues that a woman’s health and access to healthcare in Afghanistan – where maternal mortality is estimated at 1,700 deaths per 100,000 live births – is “severely jeopardised by the restrictions on her movements, her mode of dress, her presence in public places and use of public transport.”

Other countries pose different risks for mothers and pregnant women. In much of Western Africa, as well as Ethiopia, Somalia, Angola and Tanzania, fewer than half of all pregnant women have had at least one antenatal visit, according to WHO, Unsurprisingly, those same countries all boasted some of the highest maternal mortality rates in a 1990 WHO survey.

In Latin America, on the other hand, one of the greatest risks stems from unsafe abortions; the WHO estimates that all South American countries recorded rates of more than 30 unsafe abortions per 1,000 abortions in 1996. Unsafe abortions account for about a fifth of Latin America and the Caribbean’s maternal deaths, the WHO adds.

Even the United States has had problems in making motherhood safer. According to UNICEF, maternal deaths in the United States may be under-reported, and may actually be double the stated level of 10 per 100,000 live births.

One of the major problems, the agency says, is the country’s teenage pregnancy rate of 95.9 per 1,000 girls – “the highest among industrialised countries,” UNICEF contends. An estimated one million teenagers become pregnant in the United States each year, it adds, with nearly one-third of those pregnancies ending in abortions.

In many cases, family planning may help to pave the way for safer births. “With the expanded availability of family planning information and services in many countries, more and more people can make their own choices about whether and when to have a child,” said Charlotte Gardiner, a UNFPA senior technical adviser. “It’s a tragedy that many women still cannot choose to have their baby in safety.”

The inter-agency group is kicking off what it intends to be a full year of educational efforts to bolster awareness about the severity of the problem and of the need to foster safe motherhood initiatives. The campaign was supported Tuesday by U.S. first lady Hillary Rodham Clinton at a World Health Day commemoration at the World Bank.