Belgium, (Brussels Morning Newspaper) A recent United Nations report revealed that the rate at which mothers die during childbirth has failed to be reduced for the first time since records began.
The report, entitled ‘Trends in Maternal Mortality’, shows that maternal deaths either increased or stagnated in nearly all regions of the world, indicating alarming setbacks for women’s health over the past few years.
The report tracks maternal deaths nationally, regionally, and globally from 2000 to 2020. While there was significant progress in reducing maternal deaths between 2000 and 2015, gains largely stalled, or in some cases even reversed, after that point.
The highest concentration of maternal deaths is in the poorest parts of the world and in countries affected by conflict. 70% of maternal deaths are in sub-Saharan Africa, where maternal mortality rates can be over 50 times higher than in western Europe.
What makes these deaths particularly tragic is the relative simplicity of their treatment. UNICEF Executive Director Catherine Russell notes that the “knowledge and tools to treat common complications exist” and called for more equity in women’s healthcare globally.
The United Nations Population Fund (UNFPA) is responsible for sexual and reproductive health at the UN, and was part of the inter-agency group which produced the report. Its Executive Director,
Dr. Natalia Kanem, argues that greater control over reproductive health, including family planning, as well as the recruitment of 900,000 midwives, would help save hundreds of thousands of lives every year.
The deaths are caused by complications such as blood loss, unsafe abortions, and infections, which are limited in the West due to the much more widely available safe medical infrastructure. For example, pre-eclampsia is a disorder of pregnancy which is characterized by high blood pressure, which can be fatal if left undiagnosed. It is monitored during ante-natal check-ups, and, if necessary,can treated by inducing a premature birth, which on average will reduce risk of harm to mother and child. Other options include using high blood pressure medication off-label.
Not only are all of the above treatment options harder to access and finance in poorer nations and those suffering with armed conflict, but they are also much less likely to be diagnosed, where many women are also unable to access even routing ante-natal check-ups.
In the case of pre-eclampsia, there are some low-cost and low-tech solutions. The evidence suggests that chewing gum, for instance, can reduce the chances of developing pre-eclampsia. Gum with xylitol, according to a 2022 American study involving 10,000 women, can reduce gum disease which itself is associated with premature birth and low birth weights. It also works through reported stress- reduction, which can passively reduce blood pressure without medicinal intervention and therefore reduce incidence of pre-eclampsia.
According to the WHO data updated in the report, the majority of the improvement in maternal mortality over the last 30 years has been seen in East Asia and has coincided with economic growth.
Efforts in Africa, on the other hand, have in general been led by the international voluntary sector.
Economic growth has been less forthcoming in Africa than East Asia, due to lower rates of involvement in international trade and global supply chains, lower levels of personal and economic freedom, and less secure legal rights including property rights.
According to Juan Pablo Uribe of the World Bank, the plateau in maternal healthcare improvements must be understood therefore in the full context of political economy: “Addressing maternal mortality requires a comprehensive approach that addresses the underlying social, economic, and political determinants of maternal health”, he said.