Giving Birth Should Not Cause Death

After a lot of work, I succeeded in becoming pregnant for the first time at the age of 38. Like so many professional women of my generation, I had been too busy establishing my career to think much about children earlier, so I was overjoyed. It never crossed my mind that I might die in childbirth. But I almost did. The reasons I survived reveal much about women's lives worldwide.

On Saturday -- International Women's Day -- it should be axiomatic that no woman should die giving life. But a woman does die of pregnancy-related causes every minute somewhere in the world -- more than 536,000 per year. In most low-income countries, pregnancy and childbirth are the leading causes of women's death and disability. Ten million women are lost in every generation.

The reasons are many. Adolescent girls are forced to marry and bear children before their bodies are ready. Girls and women are devalued in general, their health care needs coming last in the minds of their families, their governments, themselves. They have little access to contraceptives, to health care, even basic care or to the skilled emergency care that saved my life. The political will and the investment needed to save them are sorely lacking.

In the minute you spent reading this far, 380 women just got pregnant, and half of them didn't plan it or want it; 110 women had a pregnancy-related complication, like mine. During the end of my first trimester, I almost had a miscarriage. I was hospitalized and placed on total bed rest. Like many people subjected to forced inactivity, my health continued to deteriorate. Then I almost contracted an infection.

So far my story is common to millions of women. More than 40 percent of all pregnancies everywhere suffer some kind of complication, and in 15 percent of all pregnancies, the complication is life-threatening, like mine. Infection, in fact, is one of the five leading causes of maternal death and disability. The others are hemorrhage, eclampsia or pre-eclampsia (high blood pressure), unsafe abortion and obstructed labor.

All those complications are treatable, and in the United States and other economically advanced countries, we treat them. Most women here have routine access to contraception, routine medical care, skilled birth attendants and emergency care. As a result, only one in 4,800 U.S. women will die of pregnancy-related causes. In most of Africa the rate is one in 26.

In America, I had access to the quality emergency help I needed, and today I have a wonderful 4-year-old daughter. If I were elsewhere, I would have been much closer to becoming one of my generation's lost 10 million women.

Worldwide, investment in the known solutions to these tragic statistics has declined 39 percent in the past 20 years. America used to be a leader in supporting family planning, women's health care services and the overseas organizations that provide those services, such as the United Nations Population Fund. Sad to say, this is no longer true. U.S. assistance for international family planning programs has declined in general since 1995, and is surrounded by political restrictions on free speech and medical choices.

UNFPA is the largest international organization dedicated purely to women's health. It advocates ways to improve health care systems, mobilizes communities to prepare for and respond to obstetric emergencies; and trains midwives around the world. It has won plaudits for pioneering work against maternal deaths in Bolivia, Egypt, Indonesia, Jamaica, Mongolia and Zimbabwe. But for the past six years, the United States has withheld UNFPA funding approved by Congress, and for purely political reasons.

As we observe International Women's Day, let us remind our elected officials that a country's economic and political health can be measured in the health of its women. Women can deliver for their families, their communities and their countries, but only if we deliver safe motherhood first. The United States ought to be a world leader once again in this global battle to save women's lives. We could have no greater return on our investment in the world.

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