Falling Maternal Mortality Rates: The Good and the Bad

The Lancet recently released the results of a survey, commissioned by the Gates Foundation, aiming to study the progression of maternal mortality rates from 1980-2008. Maternal mortality is defined as the death of women during childbirth, pregnancy, or in the 42 days after delivery. The New York Times reported on the findings as well.

The study provides some encouraging news: analysis of all available data for maternal mortality from 1980 to 2008 for 181 countries has shown a substantial decline in maternal deaths.

The study cited a number of reasons for the improvement: lower pregnancy rates in some countries; higher income, which improves nutrition and access to health care; more education for women; and the increasing availability of “skilled attendants” — people with some medical training — to help women give birth. Improvements in large countries like India and China helped to drive down the overall death rates.

This is great news. The reduction of maternal mortality is one of the United Nations Millennium Development Goals. There had been widespread fears that progress was slow, but it seems that there has been some movement over the past few decades:

For the first time in decades, researchers are reporting a significant drop worldwide in the number of women dying each year from pregnancy and childbirth, to about 342,900 in 2008 from 526,300 in 1980

However, there are some issues that should be noted before celebrating the decrease in maternal mortality.

1) A few countries really stand out by having exorbitant MMRs (Maternal Mortality Rates)

More than 50% of all maternal deaths were in only six countries in 2008 (India, Nigeria, Pakistan, Afghanistan, Ethiopia, and the Democratic Republic of the Congo)

Yikes. But: India has made steady progress: there were 408 to 1,080 maternal deaths per 100,000 live births in 1980, and by 2008, there were 154 to 395, the study found.

2) Sub-saharan Africa has the highest MMRs in the country; this is explained by the devastation caused by HIV/AIDS in the region. In fact, MMRs have been rising in much of eastern and southern Africa. The study notes that in the absence of HIV, there would have been 60,000 fewer maternal deaths worldwide in 2008. This finding emphasizes the need for continued research and advocacy against AIDS.

3) There is a group of people that isn't thrilled with this news: some women's health activists have spoken out against the publication of the survey, arguing that it would detract from the urgency of the cause, and slow funding and global attention for this issue. With so many issues in international development, it is understandable that funding may dry up for an issue that is perceived to have been "fixed". But it is crucial to remember that this good news has come as a direct result of aid movements and government policies, and that more funding is needed to preserve and even improve upon these gains.