COMMENTARY

Global Maternal Mortality: An Unspeakable yet Avoidable Human Tragedy

Eli Y. Adashi, MD, MS, FACOG

Disclosures

January 23, 2009

 


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Somewhere around the globe, a woman dies every single minute during or shortly after childbirth for an annual worldwide total of over 500,000 such deaths.[1] Ninety-nine percent of these preventable deaths transpire in the developing world.

Why is it that women still die needlessly in childbirth? The leading cause is obstetrical hemorrhage, followed closely by deadly infections, unsafe abortions, uncontrolled hypertension, and obstructed labor.[2] It need not be this way. Only 100 years ago, this was the state of affairs right here in the United States, a tragic situation corrected by improved asepsis, the advent of caesarean section, blood transfusion, and -- of course -- improved prenatal care.

The Millennium Development Goals -- 8 in all -- established at the 2000 Millennium Summit, constitute discreet targets that 189 United Nations member states have agreed to achieve by the year 2015. Goal 5 -- titled "Improving Maternal Health" -- aims to reduce maternal mortality by three quarters between 1990 and 2015.[3] Regrettably, progress towards this goal has been slow, characterized by mortality decrements of less than 1% per year between 1990 and 2005 -- far below the 5.5% needed.[4]

What then is the world to do? Mount a Manhattan-like project? Erect a healthcare infrastructure overnight? Or embark on incremental improvement of healthcare quality? Whatever we do, we must strive for unfettered access to family planning, antenatal care, skilled birth attendance, emergency obstetrical services, and immediate postnatal care. It is incumbent on enlightened human constructs to support and defend safe motherhood as a human right and as a health right. This after all is what it is all about, and the rest frankly is noise.

That's my opinion. I am Eli Adashi, Professor of Medical Science and Outgoing Dean of Medicine and Biological Sciences at Brown University.

 


 

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