By Michael Hirshman, RFE/RL

Every minute, somewhere in the world, a woman dies of complications in pregnancy or childbirth.

That means a total of around half a million maternal deaths each year. To address this alarming problem, the United Nations Population Fund has brought together international policymakers, government ministers, and lawmakers for two conferences in the Ethiopian capital, Addis Ababa, this week.

An Afghan mother shows off her baby in Kabul. Afghanistan suffers from one of the highest rates of maternal mortality in the world.

Aminapa Toure, the chief of the Gender, Human Rights, and Culture Branch of the United Nations Population Fund, says widespread failures in reducing maternal mortality represent a paradox. "In most societies in the world, motherhood is very valued and celebrated," Toure told RFE/RL. But "there is a deficit of attention and seriousness in terms of addressing the issue, and it is very unlikely that in many developing countries the [UN goals on] maternal health will be achieved."

The UN hopes to reduce maternal mortality by three quarters between 1990 and 2015. Of all the UN goals for development, this effort has seen the least progress in recent years.

Professor Lynn Freedman, from Columbia University's School of Public Health, who previously advised a UN task force on maternal health, says the UN's development goals are within reach.

"On its face, it is not an outrageous goal," Freedman told RFE/RL. "But the fact is, it does take a level of investment that has not been there. It takes a level of attention to implementation that has not been there, and it takes a level of political commitment and civil society commitment to put all the pieces together to make that happen. If all those things come together, it can happen."

A Matter Of Life Or Death

Childbirth remains a leading killer across much of the developing world, according to the UN Development Program's data from 2005.

Afghanistan has one of the highest maternal mortality rates in the world. With 1,800 mothers dying out of every 100,000 births, the rate in Afghanistan is comparable to those in sub-Saharan Africa.

The Afghan government has pledged to lower maternal mortality by 20 percent by 2020. But cultural and religious taboos, as well as catastrophic shortages of qualified health personnel, have made this difficult.

In Iraq, the maternal mortality rate is 300 deaths for every 100,000 births. In Iran, an average of 140 mothers die for every 100,000 births.

In most of the former Soviet republics in Central Asia, the maternal mortality rate is more than 100 deaths for every 100,000 births. That includes Kazakhstan, Turkmenistan, Tajikistan, and Kyrgyzstan.

In Uzbekistan, the official figures show a much better situation -- with only 24 mothers dying for every 100,000 births. But that figure, remarkably low for Central Asia, is suspected by some observers to be based on inaccurate data.

By comparison, the maternal mortality rate in Russia is 28 deaths per 100,000 births. In Ukraine, it is 18 deaths for every 100,000 births.

The rates are substantially higher in Georgia, Azerbaijan, and Armenia.

Meanwhile, in all countries across the developed world the rate is less than 25 maternal deaths for every 100,000 births. In the United States, for example, 11 mothers die from pregnancy or child birth complications for every 100,000 births. In Sweden, the number is just 3.

Common Causes

Columbia University's Freedman notes that five basic complications cause the vast majority of maternal deaths in developing countries: uncontrolled bleeding, infection, the consequences of unsafe abortions, prolonged and obstructed labor, and hypertensive diseases of pregnancy.

"Those three deaths in Sweden -- or in wealthy countries [in general] -- are very different from the ones in high-mortality countries," Freedman said. "So, of course, there occasionally [is] some kind of crisis [that results in] an unavoidable death in childbirth. But the vast majority of deaths in high-mortality countries [are] from a handful of very clear direct causes."

Freedman concludes that the most troublesome causes of maternal mortality are well understood by modern medicine. With proper resources, she says, there are ways to eliminate almost all of them.

The organizers of the UN conferences in Ethiopia this week hope that by drawing attention to the problem, greater steps toward eliminating the causes of maternal mortality can be made during the next decade.

... Payvand News - 10/28/09 ... --