When I started working in the field of maternal health over two decades ago, half a million women were dying in pregnancy or childbirth every year, and people were just beginning to understand the connection between women's health and economic growth. We've come a long way since then: Maternal deaths are down by almost half, and we have ample evidence that women's health and well-being are directly linked to a range of good outcomes -- from reducing poverty and hunger to ensuring healthy lives for families to promoting equitable and inclusive societies. These achievements were core targets within a set of development goals to which UN member states committed in 2000, with 2015 as the deadline.
This week, leaders from around the world have convened at the UN as they enter the final year of a lengthy, complicated process of reaching consensus around a new set of goals for 2015-2030, known as the Sustainable Development Goals. These goals will be used by governments, donors, nongovernmental organizations and the UN family itself to allocate billions of dollars and shape development policy and priorities for the next 15 years. That is why it is essential to include sexual and reproductive health and rights in the discussions this week, and in the goals themselves.
Today, more than 220 million women around the world want to avoid a pregnancy, but are not using a modern method of contraception. Some of these women lack access to services all together, some are concerned about side effects, while others cannot obtain a method that meets their needs. This huge unmet need contributes to 85 million unintended pregnancies every year, the vast majority among women who live in the world's poorest countries. When faced with an unwanted pregnancy, millions of women will decide that they are not in a position to have a child at that time. Yet, because abortion continues to be highly restricted in many developing countries, women with an unwanted pregnancy have few options. Many will resort to clandestine abortions, often performed under unsafe conditions. As a result, thousands of women will die, and many more will suffer serious and often lifelong injuries.
In addition, far too many women still lack the essential services they need to protect their health and that of their newborns, such as routine checkups during pregnancy and care for complications during delivery. This year, nearly three million infants will not survive their first month of life, and nearly 300,000 women -- many of whom never intended to become pregnant in the first place -- will die from pregnancy-related causes.
Research from the Guttmacher Institute shows the dramatic health, social and economic impact of fully meeting women's needs for contraception and other reproductive health services around the globe. The result would be far fewer unintended pregnancies (and unsafe abortions), dramatic declines in maternal and infant mortality, and reduced transmission of HIV. And the gains are far broader than improved health. Women who are able to plan their births are better able to complete their education, participate more fully and productively in the labor force, accumulate higher household savings, and raise healthier and better educated children. These family-level benefits accrue at the community and national levels as well, spurring economic development and growth. In a recent report published by the Copenhagen Consensus, 30 of the world's top economists ranked investment in sexual and reproductive health and reproductive rights among the top 13 (out of 169) targets under consideration for the Sustainable Development Goals, finding that every dollar invested in family planning reaps $150 in benefits.
By now, every UN delegate knows that a country cannot thrive if half its population -- women -- are denied the opportunity to achieve their full potential. But for that to happen, women and couples must have the information and services to be able to make decisions about their own sexual and reproductive health, including the timing and spacing of pregnancies. Access to these services is both a basic human right and fundamental to economic development.
Various UN bodies have been working intensely over the past year to mold the post-2015 development agenda. It is encouraging to see that, thus far, sexual and reproductive health has been included in most drafts and discussions related to the Sustainable Development Goals. As the governments of the world convene this week to discuss them, they need to look at the evidence. But they also need to listen to the voices of the millions of girls and women around the world for whom access to contraception and safe abortion is integral to their survival, to their health and to their well-being. Few investments reap such rewards, and ultimately, it's all of us who benefit.
Republished from the Lancet Global Health Blog