Mother's Day

HAPPY MOTHER'S DAY!



This Sunday, May, 8 2011, we celebrate Mother's Day as an American tradition. This holiday was officially started in 1914 when Anna Jarvis convinced the US Congress to designate the second Sunday of May as "Mother's Day."

As Mother's Day reaches its centennial, the United States had 82.8 million mothers celebrating this holiday in 2008, each of those mothers have an average of 2.1 children, according to Census data. In 2003, the U.S. Mortality rate was 12.1 deaths per 100,000 live births. This low maternal mortality rate and fertility rate suggest that the United States may be taking reasonably good care of its mothers. From this standpoint it is quite reasonable that we may feel more comfortable focusing on the high maternal mortality rates in Sub-Saharan Africa, the Middle East and South Asia.

This is important, mothers around the world need our advocacy and need our support as we push for greater rights for women and greater reproductive health education and implementation. Furthermore, it is true that the maternal mortality statistic is where we find the largest disparity between low-income countries and high income countries. According to the World Health Organization (WHO) , 99% of deaths during childbirth occur in low-income countries. For example, the chance of maternal death in high income countries is 1 in 7300, where as in low income countries it is 1 in 73. As young people, this is especially important and relevant because most of the young women who are dying could very well be our friends, schoolmates and classmates had they lived in a different country (particularly if they had been fortunate enough to live in a high income country as we do). The leading cause of death in young women aged 15-19 in low-income countries is from childbirth complications. This particular reality hits quite close to me because women in my family had children when they were young; my grandmother was married when she was 13 years old. I worked at a Maternity Hospital in Liberia last summer and saw girls my own age and younger in childbirth, and unfortunately in some cases, dying in child birth.

However, although US data are quite encouraging when compared a low-income country such as Liberia, in comparison to other high-income countries the United States has a high maternal mortality rate. The World Health Organization's estimate in the year 2000 of the U.S. maternal mortality was 17 deaths per 100,000 live births, 13 in the UK, 7 in New Zealand, 8 in Germany and 5 in Denmark.

These statistics are perhaps related to other reproductive health (and general health) statistics in which the U.S. lags behind other countries, such as contraceptive prevalence. In a climate of abstinence-only education, it is no wonder that our contraceptive prevalence rates are low compared to other high-income countries that tend to have comprehensive sex education.

It is also important to point out that in a country like the United States where there is high inequality, we also see inequality in maternal health statistics. According to the CDC the maternal mortality statistic in black women was 30.5 maternal deaths per 100,000 live births compared to the 8.5 rate for white women and the 12.1 rate for all races. Black women were thus more than 3 times more likely than white women to die during child birth than white women. This is simply unacceptable.

Maternal mortality is obviously an important international policy issue, improving this crisis is the 5th Millenium Development Goal (the Millenium Development Goals are a set of internationally recognized goals that many countries are striving to acheive). However it is important just as important that we back up our rhetoric about celebrating mothers with more than just fluffy holidays and ideals. The causes of maternal mortality are clear, the World Health Organization (WHO) lists the following as key reasons:



According to UNICEF, the best approach for solutions would be a holistic, continuum of care approach:

During the past decade, UNICEF has taken a holistic and rights based view of maternal health. To this end, UNICEF has been working to enhance the role of women, prevent child marriage, increase girls education, educate and abolish Female Genital Mutilation/Cutting (FGM/C), and support the development of adolescent life skills. UNICEF supports improved antenatal care (Tetanus Toxoid, Insecticide treated nets (ITN), Intermittent Presumptive Treatment (IPT), nutrition), Prevention of Mother to Child Transmission of HIV (PMTCT), increased women’s access to HIV treatment. Depending on country needs, UNICEF also supports training of skilled birth attendants (SBA), Emergency Obstetric Care programmes (EmOC) and more recently, improved newborn and post natal care initiatives.
Recent evidence, highlighted in the Lancet Series on child survival (2003), newborn survival (2005), maternal survival (2006) and on reproductive health (2006), reveal that a package of interventions, if implemented at scale, could substantially reduce both newborn and maternal mortality.

We need to press Congress to continue to fund UNFPA in a time when funding for international programs is being cut. However we can not expect this administration to do this alone and they will not without the support and advocacy from Congress (and their constituents), the public and advocates like you and I.

It is thus important that we as activists take action against maternal mortality by advocating for comprehensive sex education, safe abortion, affordable contraception and healthcare (particularly antenatal and emergency obstetric care) for low-income mothers both in the United States and abroad. This is the best way we can be assured that will make a difference in lives around the world by reducing maternal mortality rates and disparities within the United States and around the world.

TAKE ACTION:
1. Create a program at your medical school for Maternal Mortality awareness and advocacy, hold a lunch lecture, etc
2. Advocate for legislation that will fight for the reproductive health and rights of women and girls across the world
3. Educate yourself at the World Health Organization page on Maternal Mortality
4. Read more about maternal mortality in the United States from this CDC publication
5. Check out WHO's media center on maternal mortality it contains first-hand stories, informative videos and photographs
6 Learn more about Millenium Development Goal (MGD) 5: Improve Maternal Health
7. Check out this New York Times Op-Ed peice about what women's health experts would give women for Mother's Day
8. Did you know that the Taj Mahal, one of the seven wonders of the world, was built because of a woman (the Sultan's wife) who died in childbirth?