Scandal of Pregnancy Mortality
Maternal Health in Kenya

Scandal of Pregnancy Mortality

The "scandal" surrounding child-birth deaths. Who is letting women and our future generations down?

The joy a woman feels when she first finds out she is pregnant is quickly surpassed by natural feelings of apprehension. Not only about the prospect of looking after a helpless, newborn baby, but more so,  fear about the birth, with one morbidly frightening question lying deep in an expectant mothers overactive imagination, "will I die during labor?"

Surely these thoughts are insane, absurd and paranoid, as in the 21st century mother mortality during child birth are not still occurring? Thoughts about death and labor, which hamper a woman's elated joy that she is going to be a mother, are very much a real emotion of what I could honestly guess to be in every expectant mother's mind, and unfortunately are invoked with just cause and not just within the minds of women in the developing world.

According to a recent study in The Lancet, there are just as many British women dying during pregnancy and labor as there were 20 years ago, with as many as eight out of every 100,000 pregnant women dying shortly before, during or after giving birth in the UK. Given these shockingly depressing statistics it is little wonder  that the UN Secretary-General, Mr. Ban Ki-moon, has urged for a concerted effort to end what he describes as the 'scandal' of pregnancy related deaths. But how has such deaths, that one relates to a pitiful scene on Oliver Twist and a scourge of their grandparents and great grandparents era, be prevalent in contemporary society and blemishing one of the most wondrous and incredible experiences of the world, the birth of a baby?

Goal five of the UN Millennium Development Goals (MDG) is to improve maternal health and reduce by three quarters the maternal mortality ratio by the year 2015. Despite, what can only be described in the 21st century as a realistic goal, little progress has been made in saving the lives of new mothers and reducing the high risk of women dying in pregnancy or child birth, pregnancy related mortality continues unabated in sub-Saharan Africa and Southern Asia and even in the UK. Why? Who is responsible?

There are two separate issues forming in this argument, as the high maternal death rate in the UK is being blamed on a rise in obesity, an increasing number of older mothers, both of which can cause complications, and the high immigrant population in Britain, many of whom attend antenatal classes much later.

Similar issues cannot be held responsible for the 'little progresses' in diminishing maternal deaths in the developing world. Instead even more 'irresponsible' or even 'neglectfulness' within some of the world's most powerful and influential organizations can arguably be to blame. Improving maternal health is a shared mandate between different organizations; the United Nations Children Fund (UNICEF), the United Nations Population Fund (UNFPA) and the World Health Organization (WHO).

In September 2008, Jens Stoltenburg, the Prime Minister of Norway told the UN that the failure to make substantial inroads in reducing maternal mortality rates "shames us all". At the time the Norwegian Prime Minister was discussing the issue, a report issued by UNICEF had found that more than 500,000 women die unnecessarily each year due to complications in pregnancy and childbirth, most of which were in developing countries. "All this human tragedy is avoidable by simple means", said Stoltenburg in reference of UNICEF's report.

Almost two years later there is nearly an exact replica of Mr. Stoltenburg's urge for "stronger international frameworks" so that more can be done to appease such appalling human tragedies, although this time it is Mr. Ban Ki-moon who is doing the urging. So what has been hampering the goals these influential bodies and individuals have been urging from being achieved?

Of course 2008 was a year of tremendous financial uncertainty, although within the realms of the UN and WHO pumping more money into the hospitals and health services of developing countries, the global recession cannot surely be held responsible for the "lack of progress" concerning maternal deaths.

Addressing an international conference in Washington this week aimed at finding a solution to such problems affecting women and girls, Mr.  Ban said the "scandal" could be drastically reduced by improving simple medical procedures.

"Some simple blood tests, consultation with a doctor and qualified help at the birth itself can make a huge difference. Add some basic antibiotics, blood transfusions and a safe operating room and the risk of death can almost be eliminated," said Mr. Ban.

Without assistance during labor and failure of surgery or a blood transfusion if the mother's uterus ruptures, the woman is likely to die. According to UNICEF, in the US eight out of 100,000 births end in maternal death, while in Ethiopia this figure is 84 times higher. UNICEF believes every single pregnancy and birth-related death is preventable.

Like Norway's Prime Minister in 2008, the UN Secretary-General stressed the importance of global partnerships to improve the lives of expectant and new mothers. Mr. Ban highlighted at the conference that not only was the UN committed in helping governments across the globe provide greater care towards pregnant ladies, but he also talked about the new UN Joint Action Plan, designed to acceleratie progress on behalf of women and children's health and to help reach the MDG's targets by 2015.

"This plan calls for every part of the world's health infrastructure to work together, towards one goal," Ban Ki-moon told the 3,500 participants at the meeting.

Recognizing the urgency that 'no woman should have to pay for giving birth with her life', in 2009 UNFPA promised to intensify action to achieve the MDG's fifth goal to improve reproductive health by 2015. In a statement made by UNFPA in December 2009, they said they were proud of their collaboration in which they have joined forces with UNICEF, the WHO, UNAIDS and the World Bank in making progress in saving the lives of women and newborn babies in different countries around the world.

Whilst small progress may have been made, the very fact that this week's conference in Washington – the biggest ever dedicated to maternal health – had to happen, and the somewhat already 'repeated' statements and pledges made by the UN Secretary General, reveals that UNFPA, who was supposed to 'spear-head' this critical mandate, is not living up to its promises.

Let us just hope that this year 'accelerated action' and 'global collaboration' will finally and truly materialize, and that neglect of women, who according to Mr. Ban "are the glue which holds our societies and our nations together", is eradicated, and women, the spokes that keep the world turning, do not have an underlying fear that they may die during labor, darkening what should be the happiest day of their lives.

Gabrielle Pickard

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