Report: Poverty worsens maternal health

Photo: Save the Children

Save the Children recently released its annual “State of the World’s Mothers” report, which, using a wide range of statistics from 164 countries, ranks the best and worst places on earth to be a mother, a woman and a child.

The report is bittersweet for Australia. Though it ranks as the best place in the world to be a woman and the second best place after Norway to be a mother, Australia falls short on the status of children, rating only 30 out of 43 industrialised nations.

This can be attributed to the high Indigenous newborn mortality rate of about 12.3 infant deaths per 1000 births compared with the non-indigenous rate of 4.4 per 1000.

Although the current rate is obviously unacceptable, the National Indigenous Health Equality Council, which tracked national Indigenous infant mortality rates from 1998 to 2006, says the rate is dropping.

If the trend continues, it will fall into place with the rest of the nation’s population in a few years.

The worst place to be a mother in the world is Afghanistan, where one in seven women do not survive childbirth.

According to the Revolutionary Association of Women in Afghanistan (RAWA), despite US$300 million spent daily on war in Afghanistan and the more than $1 trillion of minerals in the Afghan earth, every 27 minutes a mother dies from pregnancy or childbirth complications.

“The tragedy doesn't stop with the mother's death,” Karima Mayar, a family planning team leader at the Ministry of Public Health, told Reuters’ Tan Ee Lyn in 2008.

“When the mother of a newborn dies, 75% of these babies die. Who will feed them, keep them warm? There's an Afghan saying: ‘When the mother dies, the child is sure to die.’”

The sole reason mothers in the developing world are dying at a rate of one every 90 seconds from pregnancy or childbirth complications is poverty.

The United Nations Population Fund (UNFPA) says the low social and economic status of girls and women is the fundamental reason for maternal deaths in many countries: “Low status limits the access of girls and women to education and good nutrition as well as to the economic resources needed to pay for health care or family planning services.”



Besides a basic lack in health, and midwife and obstetrical services, the UNFPA says limited access to contraceptives and family planning, excessive working conditions, poor nutrition, lack of basic education, restricted decision making capacities and early marriage all contribute to negative maternal outcomes.

Ninety nine percent of women who die from pregnancy or childbirth complications are from developing nations. But the report also draws attention to a disturbing trend in the world’s most powerful nation.

The United States, home of the most medicalised childbirths in the world, is close to being one of the worst industrialised countries for mothers. It ranks of 31 out of 43 industrialised countries and babies have a higher chance of survival in 40 other countries, including Cuba.

Despite, or perhaps partly because of, the comprehensive medicalisation of childbirth in the US (midwives are a rarity and intervention is the norm), the neonatal mortality rate has not decreased and the maternal mortality rate is actually increasing.

This rise in maternal mortality rates was highlighted in a recent report, “Deadly Delivery: The Maternal Health Care Crisis in the USA” commissioned by Amnesty International.

The report deconstructs a profit driven system in disarray, where the basic human rights to life, health and freedom from discrimination are being violated with grave consequences for the lives of mothers and their babies.

The increase in caesareans, and the poverty and inequity entrenched in the lives of Afro American and Latinas, are key reasons for these deaths.

Poverty in every country kills more babies and mothers than any war or natural disaster. Agencies like Amnesty and the UNFPA working on the front line are unwavering in their collective assurance that these deaths could be immediately prevented by accessible, available, good quality maternal and infant health care.

RAWA says that’s all the mothers in Afghanistan need to survive too. A health clinic in the Eshkashem district — which is staffed with one female doctor, two midwives, an ambulance and an operating theatre providing childbirth assistance, ante natal check ups and advice on contraception — has not had one case of maternal mortality for three years.

That’s a lot of babies who still have their mums to keep them warm.

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