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…
We’ve been doing a program in three countries in Africa [Skilled Care Initiative funded by the Gates Foundation]…We know what the interventions that work best are in different places. These were all very poor, rural communities in Burkina Faso… in Kenya, near Lake Victoria… and in Tanzania, in the absolute heart of the country…
How do you confront these countries when it comes to such sensitive issues?
In a very straightforward way. These are health issues. They don’t want their women to die... Virtually all countries in the world allow terminations of pregnancies for women under certain conditions. Six countries do not allow it for any reason… many countries do not know what their law is and they get nervous about getting too close to the edge of the law. Part of what we’re doing is helping people and physicians understand what’s legal and what’s not, and making sure women have safe services within the law and then we have to keep pushing… The head of our board is a Ghanian physician… He says that in Ghana, 30 percent of women’s deaths are from unsafely done abortions. He said there ought to be an outcry... if it were men, it would be changed in a nanosecond.
