Thursday, October 18, 2007

Action needed on maternal deaths

Experts have condemned the "appalling" lack of progress made in reducing the number of women worldwide dying during pregnancy and childbirth.

Analysis in The Lancet medical journal shows half a million women die every year - little change from 20 years ago.

And 20 million unsafe abortions - a major factor in maternal deaths and illness - are done annually.

Women at a clinic in Uganda Sub-Saharan Africa has the highest rates of mortality in childbirth

A key global target of a 75% reduction in maternal deaths by 2015 will not be met without urgent action, they warned.

Dr Richard Horton, editor of the Lancet, said women were too often seen as "containers" for babies and nothing more.

He said there should be no more excuses or delay in attempts to dramatically cut the number of deaths by three-quarters, as was set out in the Millennium Development Goals.

A study by Professor Ken Hill from Harvard University showed that maternal deaths fell by less than 1% a year between 1990 and 2005, although some countries showed better results.

Half of maternal deaths occur in sub-Saharan Africa where there has been a particularly small drop over the past two decades.

He said a "huge and urgent" emphasis was needed to improve pregnancy and delivery care in the developing world.

Unsafe abortion

In a separate study, also published in the Lancet, Dr Iqbal Shah from the World Health Organization, found rates of abortion fell globally by 17% between 1995 and 2003.



The number of women dying in childbirth varies dramatically worldwide from one in eight in Afghanistan and Sierra Leone to one in 47,000 in Ireland

Maternal health is strongly linked to access to safe abortion, contraception and emergency obstetric care

If a mother is ill or dies, the baby is less likely to survive and her other children less likely to be healthy and educated

However, the number of abortions taking place in "unsafe" conditions remained the same - about half of all abortions carried out.

The vast majority of unsafe abortions are done in developing countries, the figures show.

Abortion rates were lowest in Western Europe at 12 pregnancy terminations per 1,000 women but highest in Eastern Europe at 44 abortions per 1,000 women.

In Africa and Asia, the abortion rate was 29 per 1,000 women.

Dr Shah said rates of abortion did not differ according to whether access was good or highly restricted by law, and reducing the number of unsafe abortions was "imperative".

In Bangladesh, a massive decrease in maternal deaths has occurred because women now have access to safe abortion services and emergency obstetric care, another study by Dr Carine Ronsmans from the London School of Hygiene and Tropical Medicine showed.

Experts said the experience of Bangladesh - where abortion mortality fell by 74% over the past 30 years - shows the Millennium Development Goal are achievable.

Ann Starrs, executive vice president of Family Care International, said maternal health had a massive impact on the survival and health of children and on society.

"The general message is we still have the situation we had 20 years ago - that half a million women die every year from the complications of childbirth and 10-20 million women suffer disability."

To meet the Millennium Development Goal £3 billion ($6.1 billion) was needed by 2015, she said.

Money needs to be spent on safe abortion and family planning services and midwives who can help women access emergency care where necessary.

A spokesperson for Marie Stopes International said lack of access to modern family planning resulted in nearly 80 million unintended pregnancies every year in the developing world.

"Unsafe abortion is one of the most neglected public health issues of our time.

"The poor health of a mother, or her premature death from unsafe abortion, can have particularly detrimental effects on the health and survival chances of infants."

BBC NEWS | Health | Action needed on maternal deaths