When Planning a Pregnancy Can Save a Woman's Life

The number of maternal deaths has remained virtually unchanged for the past two decades. This is unconscionable, and it's why the Group of Eight leaders recently agreed that the world must do more.
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A new UNICEF report released last week is the latest in a series of drumbeats for a concerted, large-scale campaign to save the lives of mothers and newborns worldwide, far too many of whom are dying today from entirely preventable causes. With Congress back in session, a first order of business should be to approve a spending increase for maternal health and family planning in the FY10 Foreign Operations Bill.

At stake are the more than half a million of expectant and new mothers who die each year, 99% of them in developing countries where maternal care is scarce. That's more than one woman every minute. Yet the number of maternal deaths has remained virtually unchanged for the past two decades. This is unconscionable, and it's why the Group of Eight leaders recently agreed that the world must do more to ensure that mothers everywhere can deliver their babies safely. Here in the U.S., we can do our part by doing more to fund life-saving efforts.

When most of us think of childbirth, it triggers an image of a mother in a comfortable delivery room, holding the baby she'd dreamed of. Birth is a triumph, in part because pregnancy is never without some degree of risk. But in countries where women have a 1 in 8 lifetime chance of dying from pregnancy or giving birth, it can be tantamount to Russian roulette.

Making sure that all women can get emergency obstetric care will go a long way to improving these odds, and there are very good reasons why this type of care receives the most attention from both health providers and policymakers. But it is not enough. Education about, and access to, contraception is also critical for saving lives. That's because when women and their partners are empowered to decide if and when to have children, it can significantly reduce the likelihood that mothers will die in childbirth. Indeed, family planning as a preventive measure is unparalleled. In Africa alone, experts estimate that better access to contraception could avert more than 70,000 maternal deaths annually. More than 250,000 children would be spared the loss of their mothers.

There are broader ripple effects, too: when couples can plan how many children to have, and when to have them, they are also better able to better prepare financially for the related costs. In some cases, smaller families also make it more likely that girls will have the opportunity to go to school. No wonder, then, that the demand for family planning is vast and growing. In developing countries, 201 million women want to plan their families but still lack access to modern contraceptives. A new study [pdf] finds that adolescent contraceptive use in developing countries is rising faster than among any other age-group, as the largest generation of adolescents in history--more than 1 billion of them--enters their reproductive years.

Yet despite this increased demand and need, progress in actual contraceptive use has stagnated, or even declined, especially in parts of Africa. Access remains a major problem: Women are cut off from health care in general and from family planning information and services in particular. This is most dire in remote areas - where, not by coincidence, maternal death rates are highest, too.

In July President Obama visited La General Hospital in Accra, Ghana, where specialists from my organization and others are training local health providers to offer a range of contraceptive options at the community level and particularly in rural districts. We do this elsewhere on the continent, too, focusing on getting services to women who don't want to be pregnant now or in the near future and who live in places where regular doctor visits are virtually impossible. This work needs to be supported and expanded. In this day and age, no woman should die giving life. And no woman should die because she was unable to plan her pregnancy. The health of mothers and their children is the currency that stabilizes communities and allows for economic development. That's the message Congress needs to hear as they deliberate the proposed increase in the FY10 Foreign Operations Bill. Visit www.3for1.org to learn more about what you can do to pressure our leaders in Washington to do the right thing.

That's what family planning is about, and it's why should be included in any global effort to protect the lives of women and newborns.

Ana Langer, M.D., is the President of EngenderHealth.

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