Saving Mothers

Small measures

Posted on January 17, 2011 by admin

There was an interesting article in the Philadelphia Enquirer this weekend discussing how small measures can have a big impact on the lives of women in the developing world. The focus was on Haiti and on small, simple solutions that have the power to chip away at some very serious problems. For example, in the wake of last year’s earthquake, much of Haiti remains in ruins with a substantial portion of the population living in tent cities. Sexual violence is an everyday occurance. As a response, the U.N. Foundation has focused on providing solar-powered lighting in the camps. Better illumination increases safety, acting as a deterrent against predators lurking in the dark.

It’s an interesting example of how something so basic- lights- can have an impact on larger issues of health and safety in Haiti. According to the article in the Enquirer, ”Nowhere else in Latin America, North America, or the Carribbean is the maternal mortality rate higher, literacy rate lower, and life expectancy shorter than for women in Haiti.” In addition, teen pregnancy rates are rising even as there are fewer midwives to tend to expecting mothers.

So what kind of sustainable solutions are available here? What other small measures could help improve the day-to-day lives of Haitian women and their children? It is a clear challenge to the international community to begin thinking creatively about addressing basic issues that can ultimately lead to better health outcomes.

Link to article in the Philadelphia Enquirer

Photo credit: http://www.google.com/imgres?imgurl=http://blogs.law.columbia.edu/genderandsexualitylawblog/files/2010/09/women-haiti.jpg&imgrefurl=http://blogs.law.columbia.edu/genderandsexualitylawblog/2010/09/13/gender-based-violence-in-post-earthquake-haiti/&usg=__5zrHGoIa6qfYmgh41zxitK5prUA=&h=400&w=600&sz=104&hl=en&start=5&sig2=1a4PnaGE5YBqcRD9AgY6vQ&zoom=1&um=1&itbs=1&tbnid=fEAFhVdweZxWKM:&tbnh=90&tbnw=135&prev=/images%3Fq%3Dwomen%2Bhaiti%26um%3D1%26hl%3Den%26sa%3DN%26rls%3Dcom.microsoft:en-us%26tbs%3Disch:1&ei=4JI0Td3qH4_6swOHl8GsBQ

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Congress Fails to Pass Maternal Health Act

Posted on January 10, 2011 by admin

The Partnering to Improve Maternity Care Quality Act (H.R. 6437) was introduced in November of 2010 by Congressman Eliot Engel (D-NY) with the goal of improving the quality of services available to childbearing women and infants in the US. The bill proposed a number of measures designed to increase provider accountability and set standards of care for maternal health based on quality, efficiency, and cost-effectiveness.

However, as no action was taken on the bill before the House adjourned for the holidays on December 23^rd, the bill would need to be reintroduced by the next Congress.

The bill would have required:

The Secretary of Health and Human Services (HHS) to develop a national quality measurement program for maternal and child care. Measures intended to be evidence-based.
HHS to identify a set of maternal care quality measures for data collection, and to publish this information
The Agency for Healthcare Research and Quality (AHRQ) to develop and test a set of maternity care quality measures
AHRQ to adapt the Consumer Assessment of Healthcare Providers and Systems program surveys of providers/health plans/facilities/etc. in order to provide standardized measurements of the quality of care provided to childbearing women and newborns.
HHS to encourage clinicians, health organizations, insurance plans to provide voluntary, standardized reporting on their performance, to be made available to patients, policymakers and purchasers.
HHS to create a demonstration project to evaluate payment reforms within Medicaid
HHS to partner with the Institute of Medicine to identify key care services for childbearing women and infants.

This legislation presented an opportunity for the US in terms of quality control and potential cost-savings. The US has a history of underperformance when it comes to maternal health, so it is a disappointment that this bill was passed over in the most recent session.

Link to full text of bill

Posted in Maternal Health, Neonatal Health, Women's Rights | Leave a comment

New Poverty Matters Blog on UN Maternal Mortality Goals

Posted on December 14, 2010 by admin

The Guardian’s Poverty Matters blog has written an interesting piece on the new UN maternal mortality goals for 2015, which we had previously blogged about when they were launched in September.

The article highlights that this new strategy is different from previous initiatives in that it has garnered significant commitments not only from traditional donors such as the G8 but a large number of governments of developing countries, such as Afghanistan and Niger.

The article also highlights the latest developments: the prime minister of Canada and the president of Tanzania have been appointed as co-chairs of the commission of 25 global leaders who will steer the efforts. This group will issue a final report outlining the recommended course of action to the UN General Assembly in September 2011.

We continue to monitor the promising developments out of the UN’s initiative and will keep you updated on the Saving Mother’s blog.

Unsafe Abortions in Africa

Posted on November 20, 2010 by admin

The International Planned Parenthood Federation has released an article highlighting that 26,000 African women die as a result of unsafe abortion each year, with another 1.7mm hospitalized due to complications (out of a total of 5.5mm procedures). Sadly, the unsafe procedures include drinking bleach and inserting sharp objects into the cervix.

The article goes on to say that, according to research by the Guttmacher Institute, the need for abortions could be drastically reduced by making effective contraception available to those women who want it – they estimate that the number of unsafe abortions could be reduced from 5.2mm to 1.2mm per year.

Making effective and affordable contraceptives available to women is one of the single biggest policy changes that will promote maternal health in Africa.

Posted in Expert Opinions, Maternal Health, Uncategorized | Tagged Planned Parenthood | Leave a comment

Human Rights Watch Releases “No Tally of the Anguish”

Posted on October 9, 2010 by admin

Human Rights Watch has released a 150 page report titled “No Tally of the Anguish: Accountability in Maternal Health Care in India” which documents how tens of thousands of Indian women are dying due to childbirth, despite government programs guaranteeing free obstetric health care. The research for the report was conducted between November 2008 and August 2009, and included field research and interviews with victims, families, medical experts, officials and human rights activists in Uttar Pradesh and elsewhere in India.

You can read the press release and the full report, and watch videos related to the study, here.

Posted in Breaking News, India, Maternal Health | Tagged India | Leave a comment

U.N. Launches Global Strategy for Women’s and Children’s Health

Posted on September 25, 2010 by admin

The UN has launched the Global Strategy for Women’s and Children’s Health, announcing commitments of over $40bn by various organizations and private sector players (including UNICEF, UNFPA, UNAIDS, WHO, the World Bank, the Bill & Melinda Gates Foundation, the GAVI Alliance, and the Global Fund to Fight HIV/AIDS, TB, and Malaria in an effort to save the lives of 16mm women and children worldwide.

Read more about the effort in this article from The Medical News.

Visit the new UN website devoted to the effort, EveryWomanEveryChild.org.

Posted in Breaking News, Maternal Health, Millenium Development Goals | Tagged Millenium Development Goals, UNICEF | Leave a comment

Nigeria Holds 2-Day Conference on Maternal Health

Posted on August 30, 2010 by admin

On August 27th and 28th, Nigeria held a two day workshop for all women leaders from political parties and aspirants for the 2011 elections regarding women’s health.

According to AllAfrica.com, some of the conclusions from the conference were:

• Nigeria has achieved a 30% improvement in maternal mortality reduction. However, the current progress is still very slow. As such, there are fears that Nigeria may not achieve the MDG 5 target by 2015.

• The current reported average maternal mortality ratio at 545 maternal deaths/100,000 live births is very high and unacceptable.

• About 54,000 women die every year as a result of complications of pregnancy and childbirth. A woman dies every minute and Nigeria contributes 10 per cent of the global estimate of maternal deaths.

• The close relationship between maternal health and child survival shows that children will continue to die, despite the huge investment by government on the immunization programme. The under-five child mortality rate is very high at 157 death/1000 live births (NDHS 2008) and with over 340,000 infant deaths reported annually.

• About 40 per cent of pregnant women experience pregnancy-related problems. For every woman that dies due to pregnancy or childbirth, there are 15-20 women who suffer such complications as obstetric fistulae (VVF), ruptured uterus, hypertension, infertility and pelvic inflammatory diseases. Lack of appropriate maternal health care services, especially facilities for assisted deliveries and emergency obstetric care, constitutes a major factor

Uruguay to Achieve Millennium Goals

Posted on July 27, 2010 by admin

Despite lagging in movement towards securing sexual and reproductive health care, targeting syphilis, and monitoring mothers and their babies in the postpartum period, Uruguay has done much to reduce the maternal mortality rate, a major aspect of the fifth Millennium Development Goal. As alerted to by the IPS newswire the country has made significant progress towards lowering the maternal mortality rate, which is now the lowest rate throughout Latin America. Despite these great successes, it remains critical to target lower income communities and rural women as most of the deaths that continue to occur are understood to be avoidable. Additionally, maternal mortality and morbidity relates directly to other issues of women’s health care access, and though the rate is on target, it is important to not only focus on preventing deaths. Uruguay now has secured antenatal care for roughly 90 percent of pregnant women which has helped to lower the death rate from an average of 2.3 per 10,000 live births in the 1990′s, to 1.5 deaths per 10,000 in 2008.

Also significant to the reduction in the death rate is that while abortion remains illegal in Uruguay medical responses to such have shifted. As reported, “In 2001 it was shown that abortions carried out in unsafe conditions were responsible for 28 percent of maternal mortality.” Without changing law to allow for safe abortions, an initiative to reduce the risk of unsafe abortions with counseling and pre and post abortion examinations has enabled many women to guarantee health care access in important, albeit limited, ways. As IPS notes, “According to official statistics, there have been no deaths due to abortion complications in the country in the last two years.”

Posted in Breaking News, MDG 5, Maternal Health, Maternal Health Data, Millenium Development Goals, Women's Empowerment, Women's Rights | Leave a comment

Weekly News Roundup- Rural Health Issues Edition

Posted on July 23, 2010 by admin

On California Report, produced by Northern California Public Radio station KQED, there was a wonderful investigation of health care in rural California, where poverty rates are significantly higher than in urban zones and where access to medical care is being threatened. Check out the site and listen to the insightful program for an understanding of how maternal health care is also threatened as hospitals close and as women are often required to travel for upwards of two hours to obtain prenatal care.

Also of interest this week, and as we promised to write further about, is the issue of HIV and distance from medical centers as they negatively affect pregnant women in Swaziland. The IPS newswire reports that midwives that make use of traditional medicine are being urged to “refer all expecting mothers to health facilities for neonatal, delivery and postnatal services.” Yet as the health facilities that women are now told to travel to are often overburdened or in some cases shut down, pregnant women are losing access to care rather than gaining from trained medical providers. The reason for the change in policy was the high maternal mortality rate, yet in forcing pregnant women to travel long distances at great personal risk, perhaps instead local practitioners should gain training to respond appropriately to emergency situations.

And for more news related to the African Union summit focused on women’s health and maternal mortality concerns, the Daily Monitor has a commentary about how many governments continue to disregard the great importance of women’s health and access to health security.

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Shifts Towards Lowering Caesareans, Possible Effects on Maternal Mortality and Morbidity Rates

Posted on July 22, 2010 by admin

Today The New York Times reported about advised changes in the ways doctors should respond to the pregnancies of women who had previous Caesarean sections. The news report concluded that in many cases women who previously gave birth via C-section are able to later safely deliver vaginally. The American College of Obstetricians and Gynecologists became interested after a panel was convened to determine why in 2006 only 8.5 percent of women were having vaginal births after previous Caesarean births, down from 24 percent in 1999. With 1999 guidelines insisting that hospitals have medical teams “immediately available” in case of emergency, many hospitals prevented women from electing to have vaginal births due to fears of malpractice lawsuit and cost, as smaller hospitals were largely unable to staff the required number of doctors to have emergency teams available immediately. Yet C-sections are not without complication, and as the The New York Times notes, “Compared with babies born after a repeat Caesarean, those born vaginally after Caesarean have increased risks of stillbirth (the overall risk is well below 1 percent), but decreased risks of breathing problems and jaundice.”

Back in February, California Watch also reported on the links between maternal mortality and Caesarean section. They note that both C-sections and repeat C-sections contribute to an increased risk of complication associate with increased threat of death. As the NYT states though, for women with “one previous Caesarean, the risk of rupture during a trial of labor is quite low — from 0.7 percent to 0.9 percent. If the same woman has a repeat Caesarean instead, before labor starts, the risk of rupture is even lower — from 0.4 to 0.5 percent.” The new recommendations seek to allow women to determine their delivery method, though many doctors remain unsure if women will elect for vaginal births due to the continued advisory to have emergency staff “immediately available”. Many hospitals may continue to fear the risk of lawsuit. For more on this topic, reference the Canadian Medical Association Journal (CMAJ).

Posted in Expert Opinions, Maternal Health, Neonatal Health, Uncategorized | Leave a comment