MDG5 Digest 1

Why does maternal mortality get its own MDG?

The poor health status of women during and after pregnancy is an indication of poverty and is linked to many development indicators. The World Health Organisation (WHO) recognises that maternal mortality is one of the health indicators most closely linked to poverty around the world.  For example, among many health indicators such as infant mortality, under-5 mortality rate or adult mortality, the maternal mortality ratio (MMR) shows the widest disparity between rich and poor countries and also between the rich and the poor within a country.  Some poorest countries in the world such as Afghanistan and many sub-Saharan countries - Central African Republic, Malawi, Chad, Sierra Leone, Lesotho, Liberia, and Cote D’Ivoire - have an MMR nearly or over 1000 per 100,000 live births while the richest countries have an MMR less than 10 (see http://www.who.int/making_pregnancy_safer/topics/maternal_mortality/en/index.html )

The health of mothers also has great implications for the health and survival of their children (MDG-4).  When women die at childbirth, babies are often undelivered.  Even if women survive very difficult labour or other complications of childbirth, babies are often stillborn (see http://www.ijgo.org/article/S0020-7292(09)00365-8/abstract ).  The survival chances of live born babies whose mothers have died is reduced throughout infancy (see http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60704-0/abstract and http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2312494/?tool=pubmed ).

Other potential impacts of maternal death are various.  Children may stop going to school because of increased household chores after a mother’s death and this may be particularly true for female children (MDGs – 2 and 3).  Family disintegration following a maternal death is likely and may exacerbate children’s vulnerability.

Another important reason why maternal mortality was included in the official development objectives is that WHO acknowledges that the persistence of high levels of maternal mortality in poor countries is symptomatic of a pervasive neglect of women's most fundamental human right - the right to life-.  Maternal mortality is a rare phenomenon in the developed world because obstetric care necessary to save lives of women in complicated labour is almost universally available.  It is an obligation of governments to foster the conditions essential for life and survival for both genders in our society.

Atsumi Hirose Aug 2010