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"A woman with a voice is, by definition, a strong woman." —Melinda Gates
The death of a woman during pregnancy, at delivery, or soon after delivery is a tragedy for her family and for society as a whole. Sadly, about 700 women die each year in the United States as a result of pregnancy or delivery complications.
During pregnancy, a woman’s body goes through many changes. These changes are entirely normal, but may become very important in case there are complications or problems. A pregnancy-related death is defined as the death of a woman during pregnancy or within one year of the end of pregnancy from a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy.
Why do so many women still die in pregnancy or childbirth?
In 2015, an estimated 303 000 women will die from complications related to pregnancy or childbirth. In addition, for every woman who dies in childbirth, dozens more suffer injury, infection or disease.
The majority of maternal deaths are due to haemorrhage, infection, unsafe abortion, and eclampsia (very high blood pressure leading to seizures), or from health complications worsened in pregnancy. In all these cases, unavailable, inaccessible, unaffordable, or poor quality care is fundamentally responsible. Maternal deaths are detrimental to social development and wellbeing, as some 1 million children are left motherless each year. These children are more likely to die within 1-2 years of their mothers' death.
Women need not die in childbirth. We must give a young woman the information and support she needs to address her reproductive health needs, help her through a pregnancy, and care for her and her newborn well into childhood. The vast majority of maternal deaths could be prevented if women had access to quality family planning services; skilled care during pregnancy, childbirth and after delivery; or post-abortion care and where permissible, safe abortion services. Increased attention for women living in conflict situations, or under humanitarian crisis is needed because a working health system with skilled personnel is key to saving these women's lives.
Although the world did not achieve the Millennium Development Goal of reducing maternal mortality by three quarters between 1990 and 2015; great strides were made and many countries saw significant improvements in maternal health. Looking beyond 2015, WHO is committed to support accelerated reductions in maternal mortality by 2030, as part of the Sustainable Development Goals agenda. For this to happen, high quality reproductive, maternal and newborn health care must be available, accessible and acceptable to all in need. As part of the Ending Preventable Maternal Mortality Strategy and objectives, WHO and partners support countries to achieve this goal, so that women, girls and adolescents can survive and thrive.
Maternal deaths and disabilities are leading contributors in women's disease burden with an estimated 275,000 women killed each year in childbirth and pregnancy worldwide. In 2011, there were approximately 273,500 maternal deaths (uncertainty range, 256,300 to 291,700). Forty-five percent of postpartum deaths occur within 24 hours. Ninety-nine percent of maternal deaths occur in developing countries.
Every day, approximately 830 women die from preventable causes related to pregnancy and childbirth.
99% of all maternal deaths occur in developing countries.
Maternal mortality is higher in women living in rural areas and among poorer communities.
Young adolescents face a higher risk of complications and death as a result of pregnancy than other women.
Skilled care before, during and after childbirth can save the lives of women and newborn babies.
Between 1990 and 2015, maternal mortality worldwide dropped by about 44%.
Between 2016 and 2030, as part of the Sustainable Development Goals, the target is to reduce the global maternal mortality ratio to less than 70 per 100 000 live births.
Maternal mortality is unacceptably high. About 830 women die from pregnancy- or childbirth-related complications around the world every day. It was estimated that in 2015, roughly 303 000 women died during and following pregnancy and childbirth. Almost all of these deaths occurred in low-resource settings, and most could have been prevented.1
In sub-Saharan Africa, a number of countries halved their levels of maternal mortality since 1990. In other regions, including Asia and North Africa, even greater headway was made. Between 1990 and 2015, the global maternal mortality ratio (the number of maternal deaths per 100 000 live births) declined by only 2.3% per year between 1990 and 2015. However, increased rates of accelerated decline in maternal mortality were observed from 2000 onwards. In some countries, annual declines in maternal mortality between 2000–2010 were above 5.5%.
The Sustainable Development Goals and the Global Strategy for Women's, Children’s and Adolescents’ Health
Seeing that it is possible to accelerate the decline, countries have now united behind a new target to reduce maternal mortality even further. One target under Sustainable Development Goal 3 is to reduce the global maternal mortality ratio to less than 70 per 100 000 births, with no country having a maternal mortality rate of more than twice the global average.
Where do maternal deaths occur?
The high number of maternal deaths in some areas of the world reflects inequities in access to health services, and highlights the gap between rich and poor. Almost all maternal deaths (99%) occur in developing countries. More than half of these deaths occur in sub-Saharan Africa and almost one third occur in South Asia. More than half of maternal deaths occur in fragile and humanitarian settings.
The maternal mortality ratio in developing countries in 2015 is 239 per 100 000 live births versus 12 per 100 000 live births in developed countries. There are large disparities between countries, but also within countries, and between women with high and low income and those women living in rural versus urban areas.
The risk of maternal mortality is highest for adolescent girls under 15 years old and complications in pregnancy and childbirth is a leading cause of death among adolescent girls in developing countries.
Women in developing countries have, on average, many more pregnancies than women in developed countries, and their lifetime risk of death due to pregnancy is higher. A woman’s lifetime risk of maternal death – the probability that a 15 year old woman will eventually die from a maternal cause – is 1 in 4900 in developed countries, versus 1 in 180 in developing countries. In countries designated as fragile states, the risk is 1 in 54; showing the consequences from breakdowns in health systems.
Why do women die?
Women die as a result of complications during and following pregnancy and childbirth. Most of these complications develop during pregnancy and most are preventable or treatable. Other complications may exist before pregnancy but are worsened during pregnancy, especially if not managed as part of the woman’s care. The major complications that account for nearly 75% of all maternal deaths are:4
severe bleeding (mostly bleeding after childbirth)
infections (usually after childbirth)
high blood pressure during pregnancy (pre-eclampsia and eclampsia)
complications from delivery
The remainder are caused by or associated with diseases such as malaria, and AIDS during pregnancy.
How can women’s lives be saved?
Most maternal deaths are preventable, as the health-care solutions to prevent or manage complications are well known. All women need access to antenatal care in pregnancy, skilled care during childbirth, and care and support in the weeks after childbirth. Maternal health and newborn health are closely linked. It was estimated that approximately 2.7 million newborn babies died in 20155, and an additional 2.6 million are stillborn6. It is particularly important that all births are attended by skilled health professionals, as timely management and treatment can make the difference between life and death for both the mother and the baby.
Severe bleeding after birth can kill a healthy woman within hours if she is unattended. Injecting oxytocin immediately after childbirth effectively reduces the risk of bleeding.
Infection after childbirth can be eliminated if good hygiene is practiced and if early signs of infection are recognized and treated in a timely manner.
Pre-eclampsia should be detected and appropriately managed before the onset of convulsions (eclampsia) and other life-threatening complications. Administering drugs such as magnesium sulfate for pre-eclampsia can lower a woman’s risk of developing eclampsia.
To avoid maternal deaths, it is also vital to prevent unwanted and too-early pregnancies. All women, including adolescents, need access to contraception, safe abortion services to the full extent of the law, and quality post-abortion care.
Why do women not get the care they need?
Poor women in remote areas are the least likely to receive adequate health care. This is especially true for regions with low numbers of skilled health workers, such as sub-Saharan Africa and South Asia. Globally in 2015, births in the richest 20 per cent of households were more than twice as likely to be attended by skilled health personnel as those in the poorest 20 per cent of households (89 per cent versus 43 per cent). This means that millions of births are not assisted by a midwife, a doctor or a trained nurse.
In high-income countries, virtually all women have at least four antenatal care visits, are attended by a skilled health worker during childbirth and receive postpartum care. In 2015, only 40% of all pregnant women in low-income countries had the recommended antenatal care visits.
Other factors that prevent women from receiving or seeking care during pregnancy and childbirth are:
lack of information
To improve maternal health, barriers that limit access to quality maternal health services must be identified and addressed at all levels of the health system.
Improving maternal health is one of WHO’s key priorities. WHO works to contribute to the reduction of maternal mortality by increasing research evidence, providing evidence-based clinical and programmatic guidance, setting global standards, and providing technical support to Member States.
In addition, WHO advocates for more affordable and effective treatments, designs training materials and guidelines for health workers, and supports countries to implement policies and programmes and monitor progress.
During the United Nations General Assembly 2015, in New York, UN Secretary-General Ban Ki-moon launched the Global Strategy for Women's, Children's and Adolescents' Health, 2016-20307. The Strategy is a road map for the post-2015 agenda as described by the Sustainable Development Goals and seeks to end all preventable deaths of women, children and adolescents and create an environment in which these groups not only survive, but thrive, and see their environments, health and wellbeing transformed.
"When there are no ceilings, the sky's the limit. So let's keep going — let's keep going until every one of the 161 million women and girls across America has the opportunity she deserves to have." —Hillary Clinton
"We need to reshape our own perception of how we view ourselves. We have to step up as women and take the lead."—Beyoncé
Deaths caused by FGM, underaged marriages, child marriages, underaged forced childbirths:
Child marriage and female genital mutilation/cutting (FGM/C) are two harmful practices which disempower millions of women and girls throughout their lives. Where they exist together, the effect on girls’ lives is even greater. On International Day of Zero Tolerance for FGM, we look at what ties child marriage and FGM/C together, what makes them different, and how we can address them together.
According to the World Health Organisation (WHO) female genital mutilation/cutting (FGM/C) includes any procedure that intentionally alters female genital organs for non-medical reasons. The procedure does not have health benefits for girls but can cause severe bleeding, problems urinating, and later cysts, infections, as well as complications in childbirth and increased risk of new-born deaths.
What are the similarities between child marriage and FGM?
Both child marriage and FGM/C are driven by gender inequality and social expectations of what it means to be a girl. They are patriarchal means of controlling girls’ sexuality often linked to cultural, religious or traditional social norms.
Neither practice protects girls. Some parents and communities believe child marriage and FGM/C to be a way of protecting girls from pre-marital sex and secure a safer future for their daughters. In reality they are both violations of girls’ rights which have devastating consequences for their health, education and safety.
Both child marriage and FGM/C make girls more likely to drop out of school, and face violence, health problems, and experience complications during pregnancy.
Neither practice is endorsed by religion yet many communities interpret their faith differently and use these practices as marker of their religious identity. Getting religious leaders on board to debunk this myth is an important part of changing social norms.
“A religious leader not circumcising [sic] his daughter . . . is a much more powerful symbol than imprisoning circumcisers, or fining the family”. (Community Worker, Ethiopia.)
What are the differences?
Not all child brides undergo FGM/C and not all girls who experience FGM/C are child brides.
Child marriage is more widespread than FGM/C. Approximately 700 million women alive today were married as children while 200 million women were cut, according to UNICEF.
Whereas child marriage happens around the world, cutting across countries, cultures and religions, FGM/C happens primarily in Africa and some countries in Asia and the Middle East.
There are many places where child marriage happens while FGM/C does not. However, when FGM/C does happen, it often leads to child marriage.
How are child marriage and FGM/C linked?
In some contexts, girls undergo FGM to prepare them for marriage. In these communities, there is a social belief that un-cut girls will make unsuitable wives.
However, in certain regions, girls undergo FGM before the age of 5 but do not immediately marry, suggesting that there isn’t always a direct link between the two practices.
Some communities might reject FGM but embrace child marriage and vice versa, the relationship varies from country to country and even within countries.
“The community doesn’t accept us – the elders and religious leaders don’t have a place for uncut girls. How will they ever get married?” (Mother, Oromia, Ethiopia)
What can be done?
Research has found that sometimes when FGM/C disappears in a community; it may be replaced by child marriage. Efforts to tackle FGM/C or child marriage must bear this dynamic in mind and tackle their shared drivers and impact together.
Having stronger legal frameworks and child protection systems are the first steps but implementing this at the community level is crucial.
Challenging traditional narratives from within communities, raising awareness about the detrimental impact of both practices, and prioritising girls’ empowerment are key.
Where they exist together, child marriage and FGM/C can be stopped together to ensure girls’ education, wellbeing and safety.
FGM connected with child marriages and forced underaged childbirths are a really cruel death sentence and must be stopped forever!
"No woman should be told she can't make decisions about her own body. When women's rights are under attack, we fight back." —Kamala Harris
"In the future, there will be no female leaders. There will just be leaders."—Sheryl Sandberg
Thanks for adding your voice.
leave I am unable to care my baby.I
have decided to leave my job due to
this very short maternity leave .Requesting to Mr.Modi to extend the
maternity leave at earliest. It will help me to save my career.
Thanks for adding your voice.
It will get difficult to start to search new job with same courage.
Thanks and regards,
Mugdha Rakesh Avsare
Thanks for adding your voice.