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Frequently
Asked Questions
- How do you define maternal mortality?
- Why is maternal mortality such an important
issue for UNFPA?
- What is the scale of UNFPA’s work in this
area?
- What are the specific causes of maternal
mortality?
- What is UNFPA’s approach to solving
the problem?
- What progress has been made in preventing
maternal mortality?
- What is the Safe Motherhood Initiative?
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It refers to the death of
a woman while pregnant or within 42 days of termination of pregnancy,
irrespective of the duration and the site of the pregnancy, from
any cause related to or aggravated by the pregnancy or its management,
but not from accidental or incidental causes.
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Maternal
mortality was identified as a priority area for further action by
ICPD
+5. Death from complications of pregnancy or childbirth are
almost always preventable, with well-known and relatively inexpensive
interventions. And when a woman dies in childbirth, her other children
have a lower chance of survival. Moreover, the same interventions
that could prevent maternal mortality could also prevent acute or
chronic disability as a complication of pregnancy. By some estimates
this morbidity is as high as one in four women, and includes the
devastating condition of obstetric fistula.
Moreover,
reducing maternal mortality by 75 per cent is one of eight goals
for action in the new century as spelled out in the United Nations
Millennium Declaration of September 2000. Its inclusion in the Millennium
Development Goals is a reflection of a global commitment to reproductive
health. Maternal mortality also serves as an indicator not just
of pregnancy outcomes, but also of women's overall health, empowerment,
socioeconomic status and the availability and quality of health
services.
Strengthening maternal health
services also brings benefits to the overall health system and enhances
the impact of a country’s broader reproductive health programme.
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During obstructed labour,
the prolonged pressure of the baby's head against the mother's pelvis
cuts off the blood supply to the soft tissues surrounding her bladder,
rectum and vagina. The injured tissue soon rots away, leaving a
hole, or fistula, that results in leaking of urine or faeces. The
injury occurs most often to very young or very poor women who do
not have access to Caesarean sections to relieve the obstructed
labour. Women with the condition are often socially isolated and
abandoned by their husbands. Reconstructive surgery can mend this
injury, but most women are either unaware that treatment is available
or cannot access or afford it. Ending obstetric fistula is a major
focus of UNFPA's reproductive health branch. The Fund spearheads
the Working Group for the Prevention and Treatment of Fistula, and
is involved in many efforts to make motherhood
safer.
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UNFPA supports activities
to prevent maternal mortality in about 90 countries through support
to reproductive health programmes executed in close partnership
with UN agencies such as WHO, UNICEF, UNHCR, UNESCO, UNDP and the
World Bank. The total expenditures on reproductive health care was
about $85 million out of a total budget of about $134 million.
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More than 75 per cent of
maternal deaths are due to five direct causes haemorrhage, sepsis,
unsafe abortion, obstructed labour and hypertensive disease of pregnancy.
Another 25 per cent of fatalities are due to conditions that in
association with pregnancy precipitate a fatal outcome, including
malaria, anaemia and, increasingly, AIDS.
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UNFPA-supported
programmes work to ensure that:
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All pregnancies are wanted
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Pregnant women must have access to skilled
care at childbirth
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All pregnant women must be able to receive
emergency obstetric care when complications arise.
Although UNFPA is actively
involved in interventions in all three areas, the current focus
is on emergency obstetric care, which has not received as much attention
in the past as the other two. Most hazardous complications arise
during labour and immediately after delivery; adequate interventions
at this time can prevent death. Often, small investments in equipment
and training are sufficient to ensure that emergency obstetric care
(EmOC) is widely accessible. Basic emergency obstetric care, provided
in health centres and small maternity homes, includes the administration
of antibiotics, anti-convulsants, removal of the placenta and vaginal
delivery assisted with medical tools. Comprehensive emergency obstetric
care, delivered in district hospitals, includes all these basic
care functions, as well as caesarean section and blood transfusion.
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While
many health indicators have improved over the last two decades,
in most of the developing world, maternal mortality rates and ratios
have not declined. Two core reasons have been identified. Political
commitment and resources were inadequate, and some of the interventions
initially promoted were not effective.
However, after a decade
of advocacy, the campaign seems poised for greater success. Virtually
all countries now have safe motherhood programmes that are being
increasingly integrated with family planning and general reproductive
health services. A new emphasis on emergency obstetric
care is intended to make programmes much more effective.
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The global Safe Motherhood
Initiative was launched over 15 years ago, following a conference
in Nairobi, Kenya. It issued an international call to improve maternal
health and cut the number of maternal deaths in half by the year
2000. It is led by a unique alliance of co-sponsoring
agencies including UNFPA, who work together to raise awareness,
set priorities, stimulate research, mobilize resources, provide
technical assistance and share information. Their cooperation and
commitment have helped governments and non-governmental partners
from more than 100 countries take action to make motherhood safer.
During the Initiative’s first decade, these safe motherhood partners
developed model programs, tested new technologies and conducted
research in a wide range of countries and settings.
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