Sunday, December 19, 2010

Maternal mortality is a human rights issue

(Originally published in Guyana's Kaieteur News on 19 December 2010)

For the brief few weeks I recently focused my column on addressing domestic violence, women have been dying in stunning numbers from something totally unrelated to domestic violence – they have been dying while giving birth. It seems that during the past few months, woman after woman has died in childbirth. This is yet one more demonstration of how little society values women’s lives.

According to the International Initiative on Maternal Mortality and Human Rights (IIMMHR), “Over 500,000 women die every year from complications of pregnancy and childbirth. These tragic and preventable deaths are the culmination of human rights violations against women and girls in many aspects of their lives and at all levels of health decision-making. Ending these human rights violations is essential for preventing maternal death.”

Regardless of the results of the probe launched by the government to look into these recent deaths, there is one question that plagues my mind. Why has it taken so long for any action to be taken at all? These maternal deaths are nothing new; I wrote a column on this very topic in April 2006 as it was a problem at that time, as well.

In that column I referred to the fact that my husband’s grandmother died in childbirth over 60 years ago…from the same type of neglect and mishandling. Again, one cannot help but question why. Why are so many women dying while giving birth or shortly thereafter?

When I recently posted yet another story about a maternal death on my Facebook page, one woman’s response was, “Unbelievable! Can we rule out some sort of deliberate activity??? This is highly unusual. It’s 2010 for goodness sakes!!!”

This feeling of utter exasperation is exactly how any woman feels concerning the high number of maternal deaths.

I have had women tell me that if men were the ones giving birth, this situation would not exist. It is difficult to fight with such logic when even finding a cure for balding hair seems to take medical preference over putting an end to maternal mortality. The situation in Guyana is nothing less than a travesty that only now – after several maternal deaths in a short amount of time – an investigation has been launched to answer our questions of why. This problem of preventable maternal deaths has been around for years and a probe conducted years ago could have saved the lives of so many women.

It is time for us to recognize preventable maternal mortality for the massive human rights problem that it is. IIMMHR states, “Failure to provide available, accessible, acceptable and quality health care, including emergency obstetric care, for women during pregnancy and childbirth is a violation of women’s rights to life, health, equality and non-discrimination.

Respect and protection of women’s rights to information and decision-making in reproductive health, to freedom from gender-based discrimination and violence, and to participation in planning and implementing health policies are critical for making pregnancy and delivery safer for women.”

The April 16, 2010 Report of the Office of the United Nations High Commissioner for Human Rights on preventable maternal mortality and morbidity and human rights said, “According to WHO, UNICEF, the World Bank and other stakeholders, the majority of maternal deaths and disabilities could be prevented through access to sufficient care during pregnancy and delivery and effective interventions. This affirmation is supported by the observation that in some countries maternal mortality has been virtually eliminated. Only 15 per cent of pregnancies and childbirths need emergency obstetric care because of complications that are difficult to predict. WHO estimates that 88 to 98 per cent of maternal deaths are preventable.”

I would be numbered in that small percentage who required medical intervention while having my first child. The umbilical cord was wrapped around my daughter’s neck and even after ten hours of induced labour, I would not dilate. The child was safely delivered via caesarean section and both she and I lived. A hundred years ago, in all likelihood, we would have both died. In today’s modern world, it is a given that every woman deserves a right to a healthy delivery.

What is to be done? What can fix a system that is plagued by neglect and incompetence?

According to IIMMHR, “An effective response requires that we look beyond the delivery of quality health services and embrace the language and norms of human rights. A human rights approach to reducing maternal mortality is a powerful tool for several reasons: 1) It ensures that we can hold governments and others to account for their policies, programs, projects and pledges to reduce maternal mortality; 2) It empowers people to advocate for rights related to maternal health; 3) It offers civil society a means by which to engage in a constructive dialogue with governments around their responsibility to ensure safe pregnancy and childbirth; and 4) It places women’s equality and well-being at the center of governmental responses to reproductive rights and health issues. A human rights approach to maternal health plays a critical role in legitimizing, promoting and enforcing norms, policies and programs that seek to reduce maternal mortality.”

It is heartbreaking when the hopes and dreams of expectant parents are dashed into pieces when the mother – and possibly the child – dies during delivery when it could have been prevented. More to the point, it is a moral wrong and the inaction of the government to fix this situation years ago is simply indefensible.

In closing, some final words from IIMMHR, “Experience in various countries over the past decades has demonstrated that maternal mortality can be reduced significantly and sustainable when it becomes a political priority.

Even though dying of an easily preventable cause is a human rights violation—as much as extrajudicial executions, torture, and arbitrary detentions are—the connection between maternal mortality and human rights has not been widely recognized. The time is ripe for an effort that confronts this unacceptable situation.”

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