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Death in Childbirth: Delivering Better Odds for Women Worldwide

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It seems to happen all the time on Little House on the Prairie. A healthy woman goes into labor. Then, the face of the doctor or midwife goes pale. Cue to a commercial. The next scene is the mother’s funeral, her husband holding a newborn while the preacher offers up a prayer.

A tragedy so common in the nineteenth century should have gone the way of the horse and buggy. Instead, I was shocked to learn that women continue to die in childbirth at an alarming rate, here in the United States and around the world.

Complications from pregnancy and childbirth killed 540 U.S. women in 2004, the highest since 1977, reports Jill Sheffield, president of the women’s rights organization, Family Care International. She calls the maternal death rate of 13.1 per 100,000, “scandalous” for an industrialized nation. The United States ranks thirty-sixth of 181 countries in maternal deaths, behind Poland and just ahead of Bulgaria, she writes on the organization’s website.

Internationally, the picture is far more grim. In sub-Saharan Africa, the death rate is one in sixteen. In Afghanistan, pregnancy is almost a death sentence. One in six women dies in pregnancy or childbirth.

The issue was addressed at a London conference in October. Women Deliver drew more than 1,800 participants from 109 countries. The goal was to make the elimination of maternal deaths a high healthcare priority globally.

Many who attended, including California democrat U.S. Representative Lois Capps, vowed to do better.

“We may have dragged our feet a bit in the U.S., but we are going to hold hearings and we’re going to create a workable strategy on behalf of women,” Family Care International quoted the congresswoman as saying at the conference. “We’re going to make sure that the U.S. participates in a global effort to deliver for women around the world.”

For many advocates who have spent years trying to push maternal mortality to the forefront, the Women Deliver conference was seen as evidence of long-awaited upturn.

“There is momentum now, politically and public-wise,” says Katia Iversen, a spokeswoman for the United Nations Population Fund. “Countries don’t want to be shamed. They don’t want to be the country where a woman dies just giving birth. If shame is what it takes, then that’s what it takes.”

Part of the frustration among advocates is that the solutions to the problem are proven and documented. Women need better access to family planning, to a trained doctor or midwife at the time of delivery, and to emergency medical care if complications arise.

Women often experience heavy bleeding after childbirth, and a woman can bleed to death in just two hours, Katia told me. “You might live in a village a day’s walk from the nearest road.”

An estimated 15 percent of all pregnancies have life-threatening complications. In a hospital, a doctor can perform an emergency C-section. But for women giving birth at home, with no medical facility nearby, a complication that would otherwise be considered minor could be fatal. Infection is another common cause of maternal death.

Women in developing countries need greater access to contraceptives, so they can decide how many children they want to have and with whom they want to have them, Katia says, adding, “when women get education, they get smaller families.”

There is a tragic ripple effect when a mother dies in childbirth in a developing country. Often, her children die too, because there is no one to properly care for them.

Experts say maternal deaths could be slashed by one third with access to family planning. Some countries have made improving childbirth survival rates a priority, and they have been able to cut their deaths in half over the past quarter century. Katia cites Sri Lanka, Malaysia, and Honduras as examples.

But in the United States, the death rate has gotten worse, not better. Jill Sheffield, who founded Family Care International two decades ago after learning that worldwide, one woman dies from pregnancy every minute, reports that rising obesity, diabetes, and high blood pressure put more and more American women at risk. Too many pregnant women lack the health insurance needed to get quality care.

“Poor health care for minority U.S. women is the underlying problem,” Jill writes. “The rate for black women is nearly four times that for white women—34.7 deaths per 100,000 live births versus 9.3.”

In Norway, Great Britain, and Germany, major efforts are underway to strengthen the healthcare systems in developing countries so they can control diseases and reduce child and maternal mortality, Jill says.

Women Deliver offered hope that advocates on the front lines could soon see the payoff they’ve been working toward: fewer funerals for women who should be celebrating the birth of a baby.


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