Dying: Millions of women in childbirth, newborns, and young children

Missed opportunities

Though progress has been made toward meeting those goals, significant challenges remain.

For example, while the use of contraceptives has increased steadily, an estimated 26 percent of women in least developed countries that want to delay or stop childbearing are not using contraceptives. Unintended pregnancies contribute to high mortality and poor health for both mothers and babies, according to the analysis.

While the percentage of women who give birth with the aid of a skilled attendant, defined as an educated midwife, or similarly trained person, with access to the necessary equipment, resources and services, has increased to more than 60 percent, that leaves some 40 percent of women, mostly in Africa and Asia, giving birth without access to skilled obstetric care – 60 million births each year.

And although an estimated 70 percent of women receive at least one antenatal care visit, even in the poorest countries, the quality of care may not be sufficient. For instance, many of these visits do not include essential blood pressure readings or HIV testing and drugs to prevent HIV transmission to the baby.

“These are lost opportunities,” says Cesar Victora of Brazil’s Universidad Federal de Pelotas, a member of the Countdown to 2015 group. “We know the service was provided, but not necessarily what was provided at that visit.

“Even when the coverage is high, poor and disadvantaged women living in remote areas and ethnic groups don’t necessarily get maternal, newborn and child services. Progress should be measured not only through national averages, but also by how much the poorest mothers and children are benefiting from overall progress. It is an equity issue.”

“No woman should die giving life. All pregnancies should be wanted and every childbirth safe for both the woman and the baby,” says Laura Laski, M.D., UNFPA’s chief of Sexual and Reproductive Health, and H4 representative (WHO, UNFPA, UNICEF and the World Bank) in the planning of the mid-April meeting.