|FROM THE ISSUE | SPRING 2010
The rate of maternal deaths and illnesses worldwide is shockingly high. We can and must do something about it now. Here's one way; stay tuned for more. (This is the first of a three-part series.)
By Francine Coeytaux and Belle Taylor McGhee
The first way to lower the rate of maternal mortality globally is to improve maternal care in developing countries.
More than a third of pregnant women in developing countries have no access to or contact with health professionals before they deliver, and 57 percent of births in the developing world occur without a skilled attendant present. Such attendants are trained to identify and manage complications and refer patients to emergency obstetric care if needed. Their assistance during these complicated deliveries can literally mean the difference between life and death for both woman and child.
Obviously, we need to increase investment in maternal health-care services. Rural areas, especially, desperately need more skilled birth attendants, as well as better transportation services to emergency obstetric care—a six-hour bicycle ride to a health center is an unacceptable solution. Communities need the resources to create local birth and pregnancy-care centers, to train midwives to staff them and to procure necessary equipment, antibiotics and other vital medical supplies.
Improving existing reproductive-care facilities is also crucial. As an example, in Dodoma—the Tanzanian capital, located several hundred miles west of the country’s largest city, Dar es Salaam—Women’s Dignity, a Tanzanian-based organization that works to improve maternal health, helped the community upgrade its health centers and thus increase the number of women delivering their babies there. Recognizing that most rural women live far from such centers, the Dodoma community collaborated to build rooms at these centers where women from outside the city could stay while anticipating the beginning of labor.
Since some were concerned that they could not afford food during their stay, the centers added food supplies to their budgets. They also began offering ambulance service to transport mothers with pregnancy-related complications to the health centers.
Once these strategies were implemented, the percentage of women from the area delivering at a health center in Dodoma increased from 43 to 65 percent. Over a four-year period, the risk of maternal death was cut in half.
Similarly, training more maternity care providers who live in or can travel to remote communities increases the odds that pregnant women will receive skilled care during pregnancy and childbirth. In Afghanistan, which has a large rural population and where the health infrastructure was destroyed by decades of war, UNFPA, the United Nations Population Fund, is working with the Ministry of Health to train midwives and other health personnel who live in rural communities to provide essential obstetric services. With the highest maternal death rate in the world, only 14 percent of women in Afghanistan had skilled assistance during childbirth. We need percentages like that to go up, up, up, until all women have access to such assistance.
Excerpted from the article “Time to Save Women’s Lives” in the Spring issue of Ms. To have this issue delivered to your door, join the Ms. community.
FRANCINE COEYTAUX is a longtime women’s health advocate and a member of the board of directors of Women’s Dignity.
BELLE TAYLOR-MCGHEE, a former television news journalist,is president of the California Coalition for Reproductive
Freedom and former president and CEO of the Pacific Institute for Women’s Health.
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