Giving birth in the UK is complicated. Antenatal checks, ultrasounds, blood tests, BMI indices, dating scans and more – and that’s before delivery. Giving birth in sub-Saharan Africa is simple by comparison. You can walk five hours for a basic check-up, if able. Then again, you are far less likely to survive.
Across the developing world there are none of the integrated healthcare services for expectant mothers that are universally available in the west. That means mothers-to-be have to visit up to five different healthcare providers for services that could be provided by one clinic.
And that is after conception. The burning issue on maternal health in the world’s poorest countries is for women to take control of their own bodies and for their choices to be respected: when to have children, how often to have children, if to have children at all. Of course efforts to prevent deaths before, during and after childbirth should be a priority, but so should encouraging and empowering young women to pursue whatever life they choose for themselves. We must provide more career prospects than the baby factory alone.
This view of women as more than childbearers was a call that echoed around last week’s Women Deliver conference in Washington DC, yet the reality is that many countries still continue to care little for a more holistic approach to women’s health. To reduce maternal mortality we must address the unmet needs for family planning and reproductive health alongside the unmet needs of pregnant women. If women aren’t able to plan when they have children, then they have little chance when it comes to life’s other big decisions, including education and job prospects. If they cannot plan when to give new life, how can they plan their own life?
There was little talk too in Washington of the most vulnerable and marginalised adolescent girls, including the hardest to reach groups falling furthest behind when it comes to accessing reproductive and maternal services. Millions of these girls continue to miss out on health services. Whether this inequality is to be addressed or entrenched was unclear from last week’s discussions.
Mothers-to-be with HIV are another vulnerable group. They are up to nine times more likely to die during pregnancy if not provided with the right clinical care. And that is without addressing the stigma and rejection these women often face from health services. Many choose to forgo treatment altogether rather than face the fear this discrimination stirs.
There was insufficient mention, also, of the role to be played by that other marginalised group when debating this subject, men – for they can be hugely underrated drivers of women’s empowerment.
The conference showed the issue of maternal health sits proudly and commendably atop many people’s agendas – from politicians to activists; NGOs to philanthropists. Indeed, the latter’s Melinda Gates announced a $1.5bn fighting fund to help halt the pandemic of mother and child deaths across the developing world. There was talk of a new UN joint initiative that should be adopted by the G8 to fast-track efforts to meet the maternal health Millennium Development Goal – yet tinkering with the bolt as the sound of hooves recedes in the distance should never be proffered as best practice.
So the week’s events were not without merit, but we need a combination of new funding initiatives and political prioritisation, and the G8 summit in Canada later this month is the ideal delivery room for these commitments. Incoming international development secretary Andrew Mitchell has already talked about empowerment and accountability. Do our political leaders have the courage to deliver?
Marie Staunton, chief executive of Plan International UK.