the right to health: understanding the significance of maternal mortality

8/12/2019 The Right to Health: Understanding the Significance of Maternal Mortality

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The Right to Health

Understanding the Significance of Maternal Mortality.

Life is not a privilege; life is woman's right. A mother shold not have to ris! death every time

she "ears a child.

A p"lic health article in The LA Times recently reported the death of a healthy mother. Her life

was prematrely ct short the day after a cesarean section "y a sdden plmonary em"olism #Roan$.

Li% Logelin& at the age of thirty was yong and vi"rant; she wanted to travel the world& she had great

epectations for a happy family life "efore the pregnancy(related complication nipped all her dreams in

the "d #Logelin$. )n a nation as developed as ors& sch an event is shoc!ing; to the hs"and and child

left "ehind& it is a tragic loss. )n the hs"and*s own words& it was +the saddest& most horrific moment of

my life& and many other people*s lives, #Logelin$. -hile even one sch occrrence is rare for s in the

-est& it is an everyday event in s"(Saharan Africa where / women die each day from pregnancy

and child("irth #-H0$ ( that is one death every mintes& 1st the amont of time it ta!es for s to

"rew a cp of morning coffee.

Illustration 1: Kinney MV, Lawn, JE, and Kerber KJ, eds. !ien!e in a!tion: a"in# the li"es o$ A$ri!a%s mothers, newborns, and!hildren.& 'e(ort $or the A$ri!an A!ademy !ien!e )e"elo(ment Initiati"e *+-. /eb. +- January +10.


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That s"(Saharan Africa

with 1st 223 of the world*s

poplation shold accont for over

half of all maternal mortality

#-H0$ is grossly naccepta"le.

)nternational treaties recogni%e

health as every women*s "asic

hman right #Hnt and Mes4ita$&

yet we have failed to deliver and

neglected the pro"lem as it grows

and festers in the poorest contries that need or help the most. A mother*s death is not a solitary event&

it 1eopardi%es the very life and ftre well("eing of her yong children and tramati%es her family and

the whole commnity. Maternal mortality in s"(Saharan Africa is not merely a clinical nm"er& it is a

"reach in "asic hman rights that will re4ire not only improved medical care& "t also a commitment

to elevate the lives of all the women and girls throgh social reform. )n order for this to scceed in a

sstaina"le way& it will ta!e the cooperation and dedication of local African governments and the whole

international commnity.

Among all the other contries of s"(

Saharan Africa& nay& even of the world& Soth

Sdan& a land(loc!ed contry of 2/.52 million&

stands ot in having the highest maternal

mortality rate #MMR$ ( an incredi"ly crippling

nm"er of 6&/7 deaths for every 2//&/// live

"irths #8)A$. 9ot persistent war "t pregnancy

and child"irth has ths "ecome the leading

Illustration +:Kinney MV, Lawn, JE, and Kerber KJ, eds. !ien!e in a!tion: a"in# the li"es o$

A$ri!a%s mothers, newborns, and !hildren.& 'e(ort $or the A$ri!an A!ademy !ien!e )e"elo(ment

Initiati"e *+-. /eb. +- January +10.

Illustration : outh udan.htt(:22www.edu!ationandtransition.or#2w(3

!ontent2u(loads2+11242udan3mother3and3!hild.5(#. January+10.

6uote: outh udan: The 7i##est Threat to a /oman8s Li$e.& I'I9. 9 ;$$i!e

$or the


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case of death in women and girls. How has it "ecome this way: The cases are manifold. Soth Sdan

did not sccessflly secede from Sdan as an independent nation ntil ly 6/22. /3 of "irths were at home withot s!illed care #+Soth Sdan,$. )n

addition& edcation for girls is severely lac!ing and gender ine4ality is deeply entrenched in the

cltre& forcing teenage girls into marriage and often preventing them from receiving timely medical

care #+Soth Sdan,$. These com"inations of detrimental conditions mean that high rates of maternal

mortality is a reflection& a reslt of mch "roader social pro"lems.

Sch social factors greatly increase ris! of maternal death& and repeated pregnancy and child(

"irth pts so mch additional strain on a mother that it can reslt in chronic pro"lems and death. )n

addition& teenage girls& as yong as 27& withot flly developed reprodctive organs and wea!ened "y

malntrition and anemia are not sita"le for the long years of child("earing that is epected of them

ntil menopase #+Soth Sdan,$. Ths& "eyond 1st medical care& the women and girls in these

commnities need sanitary living conditions otside of refgee camps& they need norishing food and

edcation that gives them meaningfl opportnities otside of child(rearing.


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>// deaths per 2//&/// "irths in the United States dring the early 2>//s #Lodon& )llstration $& a rate

that is compara"le to contries in Africa li!e 8had and Somalia "t not nearly as high as MMR in

Soth Sdan. As the stdy frther indicates& maternal mortality in the 2>//s decreased the most as a

fnction of improvement in maternal care. Most crcial of the changes were s!illed attendants to

monitor the mother dring delivery and the introdction of anti"iotics that greatly decreased the chance

of death throgh pelvic infections. #Lodon 65S$. This stdy has given legislators a framewor! on

which to "ild policies for o"stetric care and highlights the necessity of targeted medical action.

As an eample& Lodon presented an important case stdy condcted in Centc!y dring 2>67(

2>5D that followed the wor! of a pioneering grop of midwives led "y Mary


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organi%ations sch as a"in# Mothers, i"in# Li$e,


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the United 9ations Millennim Smmit in 6///& along with other crcial targets sch as eradicating

etreme poverty and hnger and com"ating H)BA)=s. According to a -H0 report& the target is to

redce maternal mortality "y three 4arters "y 6/27. Some contries sch as Istonia have redced their

maternal mortality ratio "y >73 with many others ma!ing rapid progress; at the same time& S"(

Saharan Africa acconts for 7F3 of the 6G&/// glo"al maternal deaths #-H0$. There is consenss

then& that mch more rapid implementation of health programs mst "e achieved in order for

developing contries to stay on trac! and meet the goals of M=K 7.


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shown misprostol to "e especially effective& as 8hristina S. 8h and her fellow researchers report for

theJournal o$ the 'oyal o!iety o$ Medi!ine.Advocates who denonce misoprostol see it as an

inferior& 4ic! fi soltion that ta!es emphasis off developing relia"le health care networ!s #5/s "ecase it was fonded on a

standard of living that had already "een improving for the past half centry. These two go hand in hand.

As anI'I9 article has spported& we mst not lose sight that even the most "asic standard of health

care is not "eing met in Africa& things as essential as electricity at night to power lights at hospitals&

clean sheets and enogh "eds for patients #+Soth Sdan,$. At times li!e these& it may seem that or

hands are already overflowing with medical needs that mst "e addressed.


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-or!s 8ited

2. A"oahr& 8arla. +Klo"al anary& 6/2.

6.

anary 6/2.


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@al Hnt& a @rofessor of Law at the University of Isse& UC& and a United 9ations Special

Rapporter colla"orates with dith anary

6/2.

D. Logelin& Matt. +-hat Happened:, Matt& Li% and Madeline #6//G$. -e". 52 anary 6/2.

G. Lodon& )rvine. +Maternal Mortality in the @ast and its Relevance to =eveloping 8ontries Today.,

The Ameri!an Journal o$


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>. +Maternal Mortality ?act Sheet, /orld =ealth ;r#aniCation.-e". 5/ anary 6/2.

2/. 9agel& lia& anet ?leischman& and 8hristopher Letendre. +Saving MothersJ A 9ew )nitiative to

Address Maternal Mortality., mart lobal =ealth.or#. 8enter for Strategic and )nternational Stdies&

5 March 6/25. -e". 52 anary 6/2.

22. Rai& Ra1esh Cmar& Ally Ahmed& and Theodore Her%yl Tlchins!y. +@rioriti%ing Maternal and

8hild Health in )ndependent Soth Sdan.,Maternal and (226.

-e". 2G anary 6/2.

26. Roan& Shari and Kirion& Lisa. +Rising Maternal Mortality Rate 8ases Alarm& 8alls for Action.,

Los An#eles Times. 65 May 6/2/. -e". 6> anary 6/2.

25. +Soth SdanJ The


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i 9ote

i -H0 has identified the +five ma1or direct pregnancy(related conditions asJ post(partm haemorrhage&

perperal sepsis& pre(eclampsia and eclampsia& o"strcted la"or and a"ortion, #A"oahr 7$. Thesmmaries "elow are meant to provide a clearer pictre of the many complications that health

providers& wor!ing in clinics and rral villages& mst "e a"le to detect and properly treat.

2. Haemorrhage

Haemorrhage can occr dring pregnancy& "t "y far the most deadly is severe "lood loss after

delivery. 8omplications arise when "leeding from a raw ters and genital tract cannot "econtrolled& especially in villages that are far from health centers. Alternative soltions sch as

drgs and physical prohi"itors to stop "lood flow have "een implemented together with "lood

transfsions to save many lives.6. Sepsis

Historically !nown as perperal sepsis& infections from child"irth reached epidemic levels

throghot the world ntil sanitary practices and anti"iotics were introdced in developed

nations. Today& infections remain as a deadly pro"lem to mothers in developing contries;measres are "eing made to allow easier access to anti"iotics and train frontline health wor!ers

in practicing good hygiene dring delivery.

5. @re(eclampsia and eclampsia?or many years& eclampsia cased "y pregnancy was not a well nderstood condition "t is now

reali%ed to case sei%res of the nervos system and lesions in internal organs. )t is deadly

"ecase it can go ndetected "y pregnant mothers; recent programs have distri"ted "loodpressre cffs with red mar!ings that even illiterate health wor!ers can se to detect early

warning signs of eclampsia sch as elevated "lood pressre.

. 0"strcted La"or

0"strcted la"or often occrs when a "a"y*s head is not correctly aligned with the shape of themother*s pelvis& and can also "e a reslt of constricted pelvises cased "y maternal

malntrition. 0"strcted la"or can reslt in the death of "oth the "a"y and mother& and when

not fatal& can case severe "lood loss and "rea! holes in the mother*s ters. The only soltionsare mechanical maniplations of the "a"y and cesarean section; ths& there has "een an

increased psh to train "irth attendants in this life(saving procedre.

7. A"ortionA"ortions may "e either spontaneos or indced& the most concerning "eing ns!illed and

illegal operations in places with low access to health clinics in case of "leeding and infections.

This isse is "eing addressed throgh a "roader social approach of ma!ing safe a"ortionsaccessi"le to mothers and edcating commnities in contraception and family planning so that

+every pregnancy is a wanted pregnancy, #?amily @lanning =elivers$.

The information presented a"ove has primarily "een gathered from +Klo"al

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