Cross-posted from The Global Sociology Blog.
The most tragic part of this is that most of these deaths could be avoided, without too much trouble, as Kira Cochrane argues in the – ugh – …Life and Style section of the Guardian :
“The story of Yeruknesh Mesfin’s death starts on the day of her birth, in an Ethiopian village so remote that its name, Goradit, literally means “cut off”. At 10 days old, Mesfin was circumcised by a local woman, and by the age of seven, with no education, she was put to work looking after her family’s cattle. At 13, she was abducted and raped by a 32-year-old farmer, who married her; soon afterwards, she became pregnant. Without any medical advice during the whole nine months, she went into labour, “clutching her pillow, calling repeatedly for her mother while tears flowed down her cheeks”. Her husband called for help, but the complications proved too difficult for the village’s traditional birth attendant. In desperation, the men of the village carried Mesfin to the nearest hospital, where both she and her baby died. She was 15.”
This is the appalling reality faced by many women and girls, especially in developing countries where prenatal and maternal care are absent. But this is first and foremost the product of social structures that promote the abhorrent practices of female genital mutilation (FGM ) and child marriage (I call it socially sanctioned child rape). This story is the norm, not an aberration.
This story is only one from a book – Stories of Mothers Lost – published by the White Ribbon Alliance (WRA ), a coalition of organizations dedicated to the provision prenatal, maternal health care in developing countries, for the sake of safe motherhood. There is also a documentary that you can watch here , and a very moving virtual exhibit here (if you’re not moved by it, it means you’re a robot).
Becoming a mother should not be a life-threatening condition, no more than it should be imposed on women and girls (which is why the organization promotes family planning and reproductive choice).
So, how about that statistics. It is an average of course. But we know that between 500,000 and 800,000 women die in childbirth every year. The maternal death rates are very low in Western countries (see my previous post on the best and worst places in the world to be a mother). In the UK, approximately one in every 8,200 women die every year in child birth, in some developing countries, such as Afghanistan, Niger or Sierra Leone, it’s one in eight. And as Cochrane explains, 80% of these deaths could be avoided without spending billions of dollars. There is no need for expensive research or new treatments or cures. The problem is what Cochrane calls the three delays:
The first is the delay in seeking care, which may be because a woman has to wait for permission from the decision-maker of her family, because she knows the family could be bankrupted by hospital costs, or doesn’t recognise early enough that her pregnancy is running into trouble.
The second delay regards transportation, which may be unaffordable, unavailable, or simply take too long.
“Brigid McConville, director of the White Ribbon Alliance in the UK, illustrates this with the story of a female doctor she met in northern Tanzania who had encountered a woman at her clinic whose uterus had ruptured. Her baby had died, “but there was still time to save the woman’s life,” says McConville, “so the doctor kicked the generator into action, gave her an emergency hysterectomy and brought the baby out.”
One of the baby’s arms was missing. “The other attendants were saying, ‘Sister, you did this so fast, you must have cut the arm off, where is it?’ But they couldn’t find it. So the doctor went to talk to the woman’s husband, who was very quiet. It emerged that he had brought his wife to the clinic on the back of his bike – 50km, over rough track – and she had had a prolapse, and the baby’s arm had fallen out. As they cycled, this arm kept getting caught in the spokes of the bicycle, and so the man had had to decide what to do. To save his wife’s life, he had to cut the baby’s arm off.”
The third delay is in receiving care – a woman might arrive at a facility, having spent her labour on the back of a truck, only to find that there are no staff, that there is no blood for a transfusion, or that services are at a price she could never afford. Or they will arrive to find a queue around the block.
And on top of these appalling statistics, there are all the women who do not die but end up injured or disabled as a result of their traumatic pregnancies and births. One of the major consequences of this, of course, is the fistula (do yourself a favor and go watch the PBS Nova program A Walk to Beautiful ). For every woman who dies in childbirth, 30 will be injured or become disabled or ill.
What is needed is affordable health care services for women that take into account the three delays and provide care based on the specifics of each countries (for instance, what is better, a large urban hospital or multiple rural clinics that provide basic services?). Family planning services are absolutely essential to reduce these appalling statistics (I hope the next President’s move will be to rescind the murderous gag order on family planning services in developing countries, because, like it or not, access to safe and legal abortions – among the range of services – is necessary).
“This issue is naturally one that affects whole communities. Babies and young children who have lost their mothers in childbirth are up to 10 times more likely to die prematurely than their peers. McConville tells me of a woman she met in a town in Somalia, known “as the Town of Death. I was there with a journalist who wanted to photograph a family eating lunch, and we went from this ravaged street, with lots of young men lying around with Kalashnikovs – I was terrified – into this courtyard, which was a haven of peace. There were five children sitting around, eating out of a bowl in the middle, and their mother was a local nurse, called Nurta. As we talked, she said, ‘See that little boy’, and she pointed to one of the children, ‘I’ve never told him this, but he’s not my son. I was working in the town, a few years ago, during one of the waves of famine, and I found a woman who had died on the street, who had this newborn baby still suckling her breast. I couldn’t do anything for her. All I could do was to pick up her baby, and bring him home’.”
This is a shameful state of affairs that has no place in the 21st century.