By Deborah Gordis
Asunta Mucha stood barefoot on the dirt floor inside her home with both hands clutching her stomach. In excruciating pain, she tried to fight back the scream that tore at her throat. Her husband heard her agonized cry and rushed in. Pregnant with twins, Asunta needed a cesarean section but her village in Peru was three hours from the nearest hospital. This is the point when many women in the developing world die. But not Asunta.
In this case, an ambulance was available with skilled health workers to rush her to the hospital where a doctor and attendants waited for her. The next day Asunta quietly nursed her healthy baby girls. She survived because of the system in place to save the lives of expectant mothers. But about half of all women in poor countries don't have access to these kinds of services. Often, they have only their mother-in-law or husband for help.
Maternal mortality is a global tragedy. From the time you had your morning coffee today until you lift that cup again tomorrow, some 1,500 expectant mothers will die, 99 percent of them in poor countries. Most of these deaths are preventable. Every time a preventable maternal death occurs, women everywhere take a step backward. The good news: we can bring down this intolerable number.
Women share basically the same risks in pregnancy, but the difference in poor countries is access to quality health care. Most women in the U.S. get care early while women in poor countries get care too late or not at all. We wouldn't tolerate this kind of death rate for American mothers. We shouldn't tolerate it in the developing world either. No mother should be left to bleed to death when all she may need is a vial of medicine and a trained health worker to save her life.
Ensuring safe motherhood requires a long-term approach. I saw it work in Peru. CARE, Columbia University and the local Ministry of Health focused on the region with the highest maternal mortality rate. In five years they created a network to provide skilled care during pregnancy and childbirth, emergency care for life-threatening complications, immediate postpartum care for mother and newborn, and access to family planning services. That region now boasts one of the lowest maternal mortality rates in the country. That's why Asunta and her daughters are alive today.
In Peru, you can start to see glimmers of hope for improving the lives and status of women and children. But until women are highly valued in every culture, their health care needs will remain a low priority. Clearly, improved health care is necessary; but women also need to be empowered to influence health decisions for themselves and their families.
Such a cultural shift takes time, dedication and advocacy. But everyone benefits. When women are valued, families are more likely to plan ahead for better birth spacing and for emergencies that occur in pregnancy.
Together we can stimulate a movement to reduce maternal mortality -- helping societies view women as equal and invaluable, putting pressure on governments to improve maternal health, educating the media to write about these issues, and encouraging religious leaders to promote safe motherhood from their community platforms.
With a firm commitment and action from world leaders, the crisis of maternal mortality can go the way of polio - phased out village by village until it's all but unheard of anywhere in the world. We all benefit when mothers survive and contribute to the well-being of their families and communities. Asunta's twin girls, now 4 years old, are happy, joyous little girls. And their world is enormously better because of the woman raising them - their mother.
Deborah Gordis directs CARE's global Mothers Matter program. CARE fights poverty in 66 countries with a focus on empowering women and girls to bring about positive change.