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Press Release WHO/33 6 April 1998
World Health Day highlights scandal of 600,000
maternal deaths each year
Fifty years ago (7 April 1948), the Constitution of the World Health Organization came into force. In pledging to improve the health of the peoples of the world, the founding Member States also affirmed the need to pay special attention to the health of women and children and, in particular, that of mothers. It is therefore, particularly appropriate that this year the theme for World Health Day is Safe Motherhood.
Pregnancy and childbirth are special events in women's lives, and in the lives of their families. This can be a time of great hope and joyful anticipation. It can also be a time of fear, suffering and even death. Every day, at least 1,600 women die from the complications of pregnancy and childbirth. That is a minimum of 585,000 women dying every year.
In addition, each year over 50 million more women suffer from complications during pregnancy or delivery, many of which lead to long-term debilitating health problems.
Although pregnancy is not a disease, it does pose risks to the health and survival of a woman, in addition to the risks faced by the infant she bears. These risks are present throughout the world and in every setting. In developed countries they very rarely lead to death or disability because every pregnant woman has access to special care during pregnancy and childbirth. This is not the case in many developing countries where each pregnancy represents a journey into the unknown from which many women never return.
"This situation cannot be allowed to continue", says Dr Hiroshi Nakajima, Director-General of the World Health Organization. "We know what needs to be done to make motherhood safe and the resources needed are obtainable. Pregnant women need special care that is neither sophisticated nor very expensive. An investment of as little as US $3 per person could prevent most of these maternal and newborn deaths and disabilities. Women need care particularly at the critical time of birth to help ensure that childbirth is a safe and joyful event".
The scandal of maternal deaths is not only a matter of health care but also an issue of social justice. The risks that women face in bringing new life into the world are not mere misfortunes or unavoidable natural disadvantages but rather injustices that societies have a duty to remedy through their political, health and legal systems.
"It is the aim of World Health Day 1998 to stimulate countries to take a close look a the position of women in society, including their access to resources, education and health care when they most need it. This must, of necessity, involve families, communities and societies as a whole and both the public and the private sectors", says Dr Nakajima.
Around the world communities are coming together to mark World Health Day by organizing a wide range of events. Many of these focus on the role of the family in helping ensure safe motherhood. All stress that a strong national commitment is a prerequisite for success.
Asia and sub-Saharan Africa worst hit
The majority of deaths during pregnancy and childbirth - almost 90% - occur in Asia and sub-Saharan Africa; approximately 10% in developing countries in other regions; and less than 1% in the developed world. In many developing countries between a quarter to one-third of all deaths of reproductive age women are a result of complications of pregnancy or childbirth.
Of all the health statistics monitored by the World Health Organization, maternal mortality is the one with the largest discrepancy between developed and developing countries. For example, in the developing world, infant mortality is about seven times higher than in developed countries whereas maternal mortality is about 18 times higher.
Burden of disease:
For every women who dies, many more suffer from debilitating longer term health problems as a result of complications during pregnancy or childbirth. Long-term complications include uterine prolapse, fistulae, incontinence, pain during intercourse and infertility. Problems such as these currently affect as many as 300 million women.
Up to 80,000 women each year develop fistulae - holes in the birth canal that allow leakage of urine or faeces from the bladder or rectum, making a women permanently incontinent. Between 500,000 and one million women are currently living with fistulae and are unable to reach medical care where fistulae can be repaired. Many of these women become social outcasts turned out of homes and rejected by their husbands and families.
Obstructed labour - one of the most common complications - can result in permanent nerve damage and muscle deterioration in the feet and legs; women worst affected become crippled.
Additional facts and figures:
Globally there are 430 maternal deaths for every 100,000 live births. In developing countries, the figure is 480 maternal deaths for every 100,000 live births; in developed countries there 27 maternal deaths for every 100,000 live births. In Africa, one woman in 16 will die of pregnancy-related causes compared with one in 65 in Asia , one in 130 in Latin America and only in 1,800 in developed countries as a whole.
In addition to maternal deaths, the majority of stillbirths and newborn deaths could be avoided with improved maternal health, adequate nutrition and the right care during pregnancy and delivery. Each year, nearly 8 million stillbirths and newborn deaths occur, largely the result of the same factors that cause the death and disability of mothers - poor maternal health, inadequate care, poor hygiene and inappropriate management of delivery, as well as lack of newborn care.
Each year, 60 million births take place in which the woman is cared for only by a family member, an untrained traditional birth attendant - or no one at all. Only 53% of deliveries in developing countries take place with the assistance of a skilled birth attendant (a doctor, midwife or other person with midwifery skills).
Only a small proportion of women in developing countries - less than 30% - receive care after the baby is born (postpartum care), yet this is the time when most deaths occur. In very poor countries and regions, as few as 5% of women receive such care. In developed countries, 90% of new mothers receive postpartum care.
Millions of women in developing countries lack access to adequate care during pregnancy. Only 65% of women in developing countries receive antenatal care at least once during pregnancy. The figures are 63% in Africa; 65% in Asia; and 73% in Latin America and the Caribbean. In developed countries, 97% of women receive antenatal care, usually several visits during the course of each pregnancy.
World Health Day Information kit http://www.who.ch/whday/1998/index.html
All WHO Press Releases, Fact Sheets and Features as well as other information on this subject can be obtained on Internet on the WHO home page http://www.who.ch/
