This is Part 2 of a two-part interview with President Jill Sheffield of Family Care International.
Can you tell me about the origins of the global conference Women Deliver?
Women Deliver is something that’s grown out of all this work. Women Deliver is a totally new concept based on a twenty-year-old idea. The idea was that we could and we would reduce maternal mortality. In the world as a whole, women die at the rate of one very minute, mostly from preventable causes.
There are five technical reasons they die. In fact, those are the same reasons here in New York as they are in Nairobi… but they also die because they don’t have access to schools, clinic services, or contraceptives. The list goes on…
The fact is, it’s doable. Twenty years ago the WHO [World Health Organization] said, “We’re beginning to see data that suggests that maternal mortality is a big issue. Does anyone know about this?”...I happened to be sitting there and thought, “My God, of course we have to do something about this!” and it came at the time when I was working at the Carnegie Foundation… I’d been very active in family planning because when we [she and her husband] lived in Africa, I worked at the family planning outpatient clinic… and Kenya was one of the few countries that had a family planning policy… I thought women need these choices. They need to decide how many and they need to decide when…
And so in February 1987, Ann Starrs [Executive Vice President at FCI] and I organized an international meeting that asked the question of health ministers, finance ministers, researchers, and donors, “Is it happening or not?” The answer was yes, it’s happening…
There was a wonderful man there by the name of Mahmoud Fathalla from Egypt who did a spectacular conceptual presentation on “Why Did Mrs. X Die?”... Mrs. X was a stick figure on an overhead projector… Mrs. X is at the top of the road. There were turnoffs on the road (like, to school), but she couldn’t go on that road. She went further. There was no family planning and so that road was closed off. She went a little further and she was pregnant and she couldn’t get health services because that road was closed off, so Mrs. X died… There are medical reasons, but the social and cultural reasons are probably more compelling… the medical reasons are the endpoint. She bled to death or she had obstructive labor…
So Ann Starrs and I organized the meeting and got a lot of interest. A group of agencies started the Safe Motherhood Initiative, an interagency group… it included research groups and professional organizations, and it beavered away. We made some mistakes along the way. We said, “We can tell which women are going to die.” …Ten years into it, we said, “Wait, every pregnancy is at risk until you’re through it” because what we found was that half the women we said were at low risk had a complication and half the women we expected to, did not... The world must be on notice that until you’re safely through pregnancy, something can happen at any time… so we had regional and global meetings… we said, this is wrong—let’s try this.
So fast forward to 2007. It’s twenty years later. We now, technically, know how to save most of those pregnant women’s lives—and their newborns—because almost 600,000 women die, but there are four million new babies who die. If their mom dies, they’re surely going to die. If their mom doesn’t die, they still die because of the condition of the mother when she goes into labor (and if she gets care or if she doesn’t). And we’re not talking high tech expensive stuff. We’re talking practical low-resource setting care—skilled providers who have the basic necessary equipment, who have the laws in place to make it possible, that there are those people near enough for the woman to have access to them…
