Safe motherhood

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• Complications of pregnancy and childbirth are the leading cause of death and disability for women in developing countries aged 15 to 49.
  

• The lifetime risk of dying from complications related to pregnancy and childbirth is, in some countries as high as 1 in 20, and, in others, as low as 1 in 3000. As a result, the number of women who die in childbirth in a week in India is more than the number who die in a year in the whole of Europe.
  

• Accurate data are lacking for many developing countries: in some of them 50 per cent of maternal deaths are not recorded.
  

• The proportion of births attended by a skilled health worker reflects the success, or otherwise, of reducing maternal deaths. On current trends, in the developing world, only Latin American and Caribbean countries have reached the UN goal of ensuring that 80 per cent of all childbirths will be assisted by a health worker by the year 2005. Countries in the Middle East and North Africa will not reach the target even by 2010 or 2020.
  

• In Sub-Saharan Africa only 40 per cent of women have an assisted delivery, and in some countries the situation is getting worse. But the situation has improved significantly in countries such as Bolivia, Egypt, Indonesia, Morocco and Togo. In Egypt, for example the coverage of skilled attendants rose from 35 per cent to 56 per cent between 1988-2000. By contrast only six of 17 sub-Saharan states for which data are available have increased their rates since 1988.

The Causes of Maternal Death

NB. Indirect causes include, for example, anaemia, malaria and heart disease.

Other direct causes include, for example, ectopic pregnancy, embolism, anaesthesia-related.

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• Up to 25 per cent of all maternal deaths are due to pregnancy in certain groups of women - very young women, older women, pregnancy within short birth intervals and women with more than four children, and with existing health problems. Family planning services can reduce these maternal deaths and improve women's health by preventing unplanned, unintended and high risk pregnancies and reducing the need for unsafe abortions.
  

• Millions of women lack access to maternal health care that could save their lives. For example, only 53 per cent of deliveries in developing countries take place with a skilled birth attendant - doctor, nurse, or midwife.
  

• Unsafe motherhood is caused by a number of factors, including women's poor health and nutrition before pregnancy; inadequate, inaccessible or unaffordable health care; and poor hygiene and care during childbirth. Socio-economic and cultural realities also contribute, such as poverty; women's unequal access to resources, including health care, food and preventive services; their heavy physical work load, which often continues throughout pregnancy; and their lack of decision-making power in families, communities, and societies.
  

State of the World's Mothers 2004
State of the World's Newborns, published by Save the Children USA, 2001.
Safe Motherhood.
UNFPA's Maternal Mortality Update 2002.
Birth Rights: New Approaches to Safe Motherhood (Panos Briefing December 2001).
WHO Bulletin, June 2001.

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