A woman living in Africa has a life-time risk of dying from complications related to pregnancy 200 times greater than a woman living in a wealthy industrialized country, according to research findings reviewed in the May issue of the WHO Bulletin.

WHO data show that of the more than 500,000 maternal deaths that occur every year, over 99% are in developing countries and less than 1% in the industrialized world. The main causes of these deaths are unsafe abortion, haemorrhage, infections, high blood pressure and obstructed labour. A quarter to a third of all deaths of women of reproductive age are the result of complications of pregnancy or childbirth.

Maternal mortality "is the area where the difference in health outcomes between developed and developing countries is greatest," WHO Director-General Gro Harlem Brundtland told delegates at the World Health Assembly meeting in Geneva last week. "[This] difference is simply not acceptable."

"The poor fare far worse than the rest of society on all reproductive health outcome indicators. But poverty is not an insurmountable barrier to health when there is a high level commitment to investing in health," a Bulletin article says. "Gender-based discrimination is an important determinant of poor reproductive health. Women suffer the major burden of sexual and reproductive ill-health because they also suffer discrimination in access to basic needs, health services and the exercise of human rights."

Another Bulletin article reviews data suggesting that making abortion safer could save the lives of many thousands of women a year.

Globally, deaths from abortion account for at least 13% of all deaths during pregnancy, delivery and the postpartum period . Every year 20 million women undergo unsafe abortions, as a result of which an estimated 80 000 of them die, the article says. It adds that almost all of the deaths occur in developing countries, and that unsafe abortions in Africa are at least 700 times more likely to lead to death than safe abortions in developed countries.

Reproductive health, including maternal health, is the subject of the special theme section of the May Bulletin. Other articles in the theme section of the journal deal with the quality of hospital obstetric care, perinatal mortality, family planning and control of sexually transmitted diseases.

The May issue of the WHO Bulletin is available on the Internet: http://www.who.int/bulletin/

For further information, journalists can contact Mrs Carla Abou-Zahr, Theme Editor of the May 2000 issue of the WHO Bulletin, WHO, Geneva. Telephone (+41 22) 791 3367. Fax (+41 22) 791 4858. Email: abouzahrc@who.int

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