Dollars and Sense...Investing in Mothers

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Sean Sheridan

Over the past decade, rates of infant, child, and maternal deaths have decreased significantly. The efforts to reach the underserved are really making a difference and have resulted in big improvements. But with more than 300,000 woman dying from pregnancy-related causes each year, we still have a long way to go. While there are many ways to save lives, one of the simplest and most cost-effective is contraception.

Family planning? To save the lives of mothers? Yes! And how it works is relatively straightforward. Scientists have identified four ways that family planning can reduce maternal deaths. The first one is simple: if a women does not become pregnant (through contraceptive use) then she avoids the risk of pregnancy-related complications that can lead to her dying. Second, by avoiding unplanned pregnancy (through contraceptive use) fewer women will seek abortion, which for many women around the world, is an unsafe procedure that is responsible for about 13 percent of all maternal deaths, according to the World Health Organization (WHO). Third, for young women who are not yet developed sufficiently from a physiological perspective, use of contraception can avoid life-threatening pregnancies that occur at an early age. And fourth, for older women who have already had many pregnancies, the risk of additional, high-parity, high-risk pregnancies can be reduced through contraceptive use. Researchers from Johns Hopkins, the London School, and the Guttmacher Institute independently estimate that if women who wanted to avoid becoming pregnant used effective contraception, maternal deaths could be cut by about 30 percent—that’s close to 100,000 maternal deaths averted by family planning each year.

What is really interesting is that, while access to affordable, modern methods of family planning has the potential to save approximately 100,000 additional lives, I often forget the extent to which it is already saving mothers’ lives. One estimate, based on data from the WHO, indicates that if no women used contraception, the number of maternal deaths each year would be over 600,000—practically twice the estimated number of maternal deaths that do occur each year. While other causes of maternal death include severe bleeding during childbirth, sepsis, infection, obstructed labor, and high blood pressure during pregnancy and delivery—all of which require access to medical services—the role that family planning can play in preventing maternal deaths is undeniable.

While the loss of life is a tragedy in itself, the death of a mother has negative personal and economic impacts that ripple through the family, affecting subsequent generations and the community. An immediate consequence is a much higher risk of the woman’s newborn child dying—as many as 81 percent of neonates died in Ethiopia following their mothers’ death. Families are left with health care debts incurred by the mother, as well as her funeral costs. Responsibilities for caring for the orphaned children place on female relatives an additional financial burden that can directly affect the nutrition, education, and health of surviving children. Ultimately, a woman’s surviving children can experience limited opportunities for employment, and daughters may fall victim to early partnership, marriage, and pregnancy. The family’s social fabric becomes frayed and quickly begins to unravel when a mother dies.

Don’t get me wrong…family planning won’t save all mothers’ lives and it is not the only solution to remedy the complex challenges a woman or her children face. But it is a straightforward intervention that already saves the lives of hundreds of thousands of women each year, and can help save thousands more. It's also smart economics. The return on investment for lowering rates of maternal and infant mortality through reducing unplanned pregnancies alone is estimated to between $30 and $50 for each dollar invested. We have learned a lot about providing family planning in recent decades, and one of its important benefits is that it helps reduce the number of high-risk pregnancies that undermine the lives of women on a global basis. It’s an investment that, at least to me, makes dollars…and a lot of sense.

Read more about the dollars and sense of investing in family planning.

Learn what the Health Policy Plus project is doing to strengthen maternal health and respectful maternity care.

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