Pregnancy Related Deaths Declining Globally

The United Nations (UN) estimates that 1,000 women die per day from pregnancy-related causes around the world.  While this number is down from a decade ago, the UN charges that more needs to be done to achieve the goal set by the Millennium Development Goal (MDG) of a 75% reduction in maternal mortality ratio between 1990 and 2015.

A new report, Trends in Maternal Mortality released by the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the United Nations Population Fund (UNFPA) and the World Bank reveals that the mortality rate of women due to complications during pregnancy and childbirth has decreased by 34%, from about 546,000 in 1990 to 358,000 in 2008.

When the MDG was set, the required annual decline was 5.5%.  At this point, the rate of annual decline has only been 2.3%. 

"The global reduction in maternal death rates is encouraging news," says Dr Margaret Chan, the Director-General of WHO. "Countries where women are facing a high risk of death during pregnancy or childbirth are taking measures that are proving effective; they are training more midwives, and strengthening hospitals and health centers to assist pregnant women. No woman should die due to inadequate access to family planning and to pregnancy and delivery care."

Based on information gathered regarding 1,000 women who died in 2008 from pregnancy or childbirth issues, 570 lived in sub-Saharan Africa, 300 lived in South Asia and 5 in high-income countries.  The most common causes of death are severe bleeding after childbirth, infections, hypertensive disorders and unsafe abortions.

The risk of dying from pregnancy related causes is about 36 times higher in women living in a developing country compared to a woman living in a developed country.

"To achieve our global goal of improving maternal health and to save women's lives we need to do more to reach those who are most at risk," says Anthony Lake, Executive Director of UNICEF. "That means reaching women in rural areas and poorer households, women from ethnic minorities and indigenous groups, and women living with HIV and in conflict zones."

The decline in pregnancy mortality is evidence that it is possible to prevent these deaths.  Health systems and quality of care must be a priority for these countries, requiring investment of time and money.

"Every birth should be safe and every pregnancy wanted," says Thoraya Ahmed Obaid, the Executive Director of UNFPA. "The lack of maternal health care violates womens' rights to life, health, equality, and non-discrimination. MDG5 can be achieved," she adds, "but we urgently need to address the shortage of health workers and step up funding for reproductive health services."

WHO, UNICEF, UNFPA and the World Bank have targeted countries with the greatest burden and focused to help governments in the development of their national health plans to expedite progress in maternal and newborn health.  UN agencies, donors and other partners have worked together in a combined effort to help these countries meet the MDGS goal.

"Maternal deaths are both caused by poverty and are a cause of it. The costs of childbirth can quickly exhaust a family’s income, bringing with it even more financial hardship," says Tamar Manuelyan Atinc, Vice President for Human Development at the World Bank.

Tamar continues, "Given the weak state of health systems in many countries, we must work closely with governments, aid donors and agencies, and other partners to strengthen these systems so that women gain significantly better access to quality family planning and other reproductive health services, skilled midwives at their births, emergency obstetric care, and postnatal care for mothers and newborns."

Report highlights from 1990 to 2008:

    * Ten out of 87 countries with maternal mortality ratios equal to or over 100 in 1990, are on track with an annual decline of 5.5% between 1990 and 2008. At the other extreme, 30 made insufficient or no progress since 1990.
    * The study shows progress in sub-Saharan Africa where maternal mortality decreased by 26%.
    * In Asia, the number of maternal deaths is estimated to have dropped from 315 000 to 139 000 between 1990 and 2008, a 52% decrease.
    * 99% of all maternal deaths in 2008 occurred in developing regions, with sub-Saharan Africa and South Asia accounting for 57% and 30% of all deaths respectively.

"We still need to do more to strengthen national data collection systems," says Dr Chan. "It is vital to support the development of complete and accurate civil registration systems that include births, deaths and causes of death. Every maternal death needs to be counted," she adds.

WHO news release states, "The UN maternal mortality estimates are developed in close collaboration with an international expert group and use all available country data on maternal mortality, as well as improved methods of estimation. The intensive country consultation carried out as part of the development of these estimates has been instrumental in identifying increased data collection efforts in recent years including the special systems to capture data on maternal deaths. There are however major gaps in the availability and quality of data for many countries where maternal mortality levels are high, and only through statistical modeling is it possible to obtain an understanding of the trend."

Next week a conference in New York, with the purpose of reviewing the MDG, will bring together 140 heads of state

Phil Hay, an advisor to the World Bank development office that is dealing with health and education issues at the summit, said, "Look, these goals are due by 2015.  What are we going to do as a development community to make sure all this happens by 2015?"

Phil Hay, advisor to the World Bank development that is dealing with health and education issues at the conference said, "World Bank is prepared to make a significant monetary contribution toward achieving the Millennium goals in 35 of the poorest nations with the highest rates of maternal mortality."

"These are mostly going to be countries in sub-Saharan Africa and South Asia.  And we are prepared to spend up to $650 to $700 million in new financing to make sure that by 2015, we put an end to the unfinished business of trying to keep mothers alive," said Hay.

Hays said, "the United Nations will make a major effort during the next five years toward achieving the Millennium goals, which also include reducing childhood mortality, eliminating hunger and disease, and halving extreme poverty around the globe."