Safe motherhood最新文献

"1370 mothers reported killed during physiological duty. Thousands more seriously injured." That was the startling news headline envisioned by Dr. Mahmoud Fathalla of Egypt in a statement to the first regional congress of the Medical Women's International Association for the Near East and Africa. If there was a global newspaper on reproductive health, it could publish that same headline every day, year after year, Dr Fathalla said. Maternal mortality is more than a health issue, it is a human rights issue, Dr Fathalla told participants at the congress, held 29 November to 3 December last year in Nairobi, Kenya. Malaria kills more than the half-million women who die of maternal causes each year, but to compare maternal mortality with deaths from disease is to miss the point, he said. "Pregnancy is not a disease," Dr. Fathalla told the congress. It is good if people do not get diseases such as tuberculosis or cancer, but if the human race is to survive women must become pregnant. They should not have to pay with their lives, because the knowledge and skills to prevent maternal deaths are attainable if the political will exists." Dr. Fathalla was pessimistic about prospects for attaining the Safe Motherhood goals of cutting maternal mortality by half by the year 2000. Mothers continue to die from pregnancy-related causes because societies make a rational decision not to invest in the lives of women, he said. Women's unpaid work in production and reproduction does not feature in national accounting, Dr. Fathalla pointed out. Women suffer discrimination from the start of their lives in terms of nutrition, access to health care and education. Expectations of women are so low it may even seem rational not to invest resources to prevent maternal mortality. Many of the countries with the highest levels of maternal mortality continue to allocate more of their scarce resources to "men's dangerous hobby, war, euphemistically called defense" than to health and education, he added. It is time to get angry, Dr. Fathalla concluded. He called on congress participants to demand that societies invest in women, not simply because of the benefits to children but because women deserve no less than the best.

Public attention is being focused on safe motherhood in Pakistan as a result of community meetings about the causes of maternal death. The Mother and Child Welfare Association of Faisalabad holds the meetings -- called "maternal death meetings" -- to stress the community's role in preventing maternal death. Since January 1989, the welfare association has been compiling details of all maternal deaths in the city of Faisalabad. There were 48 recorded maternal deaths in 1989, 55 in 1990, 41 in 1991 and 37 in 1992. The association interviews relatives of the deceased mother, physician or TBA to find out the cause of death and any avoidable factors. The aim is to discover just how preventable the death was and what measures should be taken to prevent a death like that in the future. The maternal death meetings point out how appropriate actions of mothers, TBAs and relatives as well as of medical professionals can contribute to preventing maternal deaths. Women get information and advice about maternal health and family planning at the meetings. The association's president, Professor Altaf Bashir, says the meetings have increased public awareness of the problem and made women and TBAs more aware of the damage done by certain practices to speed delivery.

Nigeria's National Task Force on Vesico-vaginal Fistula has published a booklet to draw public attention to the problem of fistulae. The 20-page booklet explains how fistulae happen and what can be done to prevent them. It makes clear that early marriage and early pregnancy are major causes of fistulae that lead to the social rejection of many young women. The booklet tells the story of two girls in a series of color pictures with accompanying text in Hausa and English. One girl is given in marriage to an older man at the age of nine, becomes pregnant before she is fully grown, suffers obstructed labor, is denied obstetric care and is left with a vesico-vaginal fistula. With urine leaking from her bladder through her vagina, she smells constantly of urine and is thrown out of the house by her husband. Her parents also reject her and she is reduced to begging until one day she hears of a hospital where fistulae can be repaired. After the repair she is warned that if she has any more babies they must be delivered in a hospital. The other girl is not given away in marriage but goes to school, graduates from university and marries a man of her choice. She becomes pregnant only when her body is fully developed, attends the antenatal clinic, has an easy labor and safe delivery.