Becoming a mother was not the blissed-out, exhilarating experience I thought it would be. It was painful, scary and the only time I have ever felt truly out of control. When I went to the hospital, I was expecting an “easy” birth. My pregnancy had not been particularly difficult, and I was slated to deliver in the hospital’s birthing center—but then there were complications.
Ultimately, I had an emergency cesarean section. I have only the faintest memory of my daughter’s entrance into the world. I didn’t hold her on my chest after hearing her first cries. I don’t even remember her first cries. And I didn’t bond with her after her birth—she went one way and I went another.
To say I was disappointed would be an understatement. But here’s the thing: Becoming a mother didn’t cost me my life. Not even close. There was never any danger of that. And it didn’t cost my daughter hers either. She went to the NICU and was attended to by an expert team of doctors and nurses.
Some moms aren’t so lucky.
Around the world, one woman dies every two minutes from complications in pregnancy and childbirth—almost 800 moms every day. Ninety-nine percent of these deaths occur in the developing world, with about one-half occurring in sub-Saharan Africa and Southern Asia. Millions more women suffer from injury, infection or disease during pregnancy or childbirth.
The shocking thing? The vast majority of maternal death and injury is preventable.
The common causes of maternal death are well known: severe bleeding during or after childbirth; hypertension, or high blood pressure, during pregnancy; sepsis and infections; prolonged or obstructed labor; and unsafe abortion. Effective, life-saving interventions exist for all of these causes—but for many women, lack of access to quality reproductive and maternal health care quite literally means death.
Afghanistan once had the highest maternal mortality ratio in the world, with estimates as high as 1,800 deaths per 100,000 live births. Although still unacceptably high, the latest survey of maternal death in Afghanistan shows a steep decline, to 327 deaths per 100,000 live births, though this number may be as high as 500 deaths per 100,000 live births given survey restraints. Several factors contributed to this drop, including increases in antenatal care and assisted deliveries, made possible by increases in the number of health facilities and the number of trained midwives, which has more than tripled since 2002. The Feminist Majority Foundation (publisher of Ms.) was involved in the efforts to train and mobilize more midwives in Afghanistan, and we did that because we knew it would save lives.
Access to family planning also saves lives. Achieving universal access to reproductive healthcare and family planning is part of the United Nations Millennium Development Goal to reduce maternal mortality by three-quarters by 2015, but still an estimated 222 million women around the world who wish to either delay or prevent pregnancy lack access to contraceptives. According to research by the Guttmacher Institute, meeting the contraceptive needs of these women would prevent 54 million unplanned pregnancies per year as well as 79,000 maternal deaths, mostly in sub-Saharan Africa, and 16 million unsafe abortions. Children would benefit too; meeting the demand for contraceptives would prevent over 1 million infant deaths.
The United States, of course, has a big role to play in meeting the need for contraception worldwide, but current funding for international family planning and reproductive health programs will not allow for these ambitious goals to be met. U.S. funding for these programs has remained stagnant since 2012, despite calls for the U.S. to raise its level of funding to $1 billion, representing its fair share of global aid. Around the world, women are also unable to access contraception at PEPFAR sites meant to help reduce the rate of HIV/AIDS.
Investing in family planning yields high returns. Every $1 spent on family planning saves $4 in other development costs in areas such as water and sanitation, maternal health and education. But more importantly, it saves lives. The United States must show itself to be a true global leader in reducing maternal death. This is especially important for adolescent girls. Complications from pregnancy and childbirth are the leading cause of death for girls ages 15-19 in poorer countries. And the risk of maternal death for girls 14 and under is double that of adult women. These younger girls also face higher rates of obstetric fistula.
To fully combat maternal death, however, we need to take an even broader approach. We must empower women and girls economically and socially, confront sexual violence and conflict and provide comprehensive health care, including access to safe abortion to women and girls who are victims of war rape. We must end child marriage and ensure that girls everywhere have access to basic education.
We are not short of ideas.
Let the spirit of Mother’s Day continue this week by taking action: Let’s start educating ourselves and our representatives on the need for more international family planning funding. Let’s continue to ask for more aid and continuous support for places like Afghanistan that are still developing quality reproductive and maternal health care systems. And let’s pledge never to stop calling attention to the war on women’s rights and human rights—in the U.S. and around the world.