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Press Release
: Lynnette Johnson Williams
25 September 2002

Promises To Keep: The Toll of Unintended Pregnancies on Women's Lives in the Developing World

A new Global Health Council report is the first-ever global analysis of the impact of unintended pregnancies on maternal deaths in developing countries. The report, "Promises to Keep: The Toll of Unintended Pregnancies on Women's Lives in the Developing World," details more than 300 million unintended pregnancies and the resulting deaths of nearly 700,000 women between 1995 and 2000.

"Most of these unintended pregnancies and needless deaths could have been prevented had basic reproductive health services been made available to these women. Failure to provide women with the means to plan, prevent or appropriately space their next pregnancy poses an extraordinary public health threat, one that can readily be addressed with modest resources," said Nils Daulaire, President and CEO of the Global Health Council, who released the report on Sept. 25 at a Washington briefing.

"The report confirms the strong correlation between maternal mortality and inadequate access to quality reproductive health. Reproductive health is about saving lives," said Daulaire.

The Global Health Council conducted this comprehensive analysis as a statistical measure for assessing progress on pledges to reform and fund reproductive health services made at the 1994 International Conference on Population and Development (ICPD). The study was designed to determine whether the further extension of voluntary reproductive health services might play a significant role in reducing deaths of women due to complications during pregnancy and childbirth.

According to the Council's analysis, between 1995 and 2000, the world's 1.3 billion women between the ages of 15 and 45 experienced more than 1.2 billion pregnancies. Of these, more than 300 million - or more than one quarter - were unintended. Over those six years, nearly 700,000 women died from unintended pregnancies. While more than one-third died from the myriad problems associated with pregnancy, labor and delivery, the majority - over 400,000 - died as a result of complications resulting from abortions carried out in unsafe, unsanitary and often illegal conditions.

The deaths detailed in the report were the result of inadequate access to effective reproductive health services, poverty, ignorance, social and economic marginalization, and entrenched gender bias.

"These deaths are a reflection of the failure of the international community to live up to the ICPD commitments made to the world's women - to assure that they will have access to the reproductive health services that could prevent them," Daulaire said.

The report confirms the consequences of the growing disparity between healthcare available in industrialized nations and in the developing world. Women in some developing nations run several hundred times the risk of dying during pregnancy and childbirth compared to their counterparts in wealthier nations. In North America and Europe, one woman in 4,000 is likely to die from maternal causes. In Africa, one of every 15 women will die of these causes.

The reasons for this continued high prevalence of maternal mortality are complex, the result of flagging funding for essential health services, and the low priority placed on women's reproductive health.

Maternal mortality is highest in countries where women are least likely to have access to modern contraceptive services and in those countries where women do not have access to trained birth attendants or any type of care during labor and delivery. In Burkina Faso, where only four percent of women use family planning methods, one in 14 will die of maternal causes over the course of her lifetime. In Brazil, the opposite is true; nearly three-quarters of the female population regularly use family planning services and their lifetime risk of maternal mortality sinks to one in 130.

"We also found that where women have little or no access to simple and reliable methods of contraception, an unintended pregnancy often leads to the decision to have an abortion," Daulaire noted. Deaths as a result of unsafe abortions account for 64 percent of the nearly 700,000 women who have died as a result of unintended pregnancies since 1995.

The analysis of national data demonstrates that in countries where women desire to limit their family sizes and have access to family planning services, the number of women both seeking abortions and dying as a result of them remains relatively low.

With funding from The David and Lucile Packard Foundation, the Council compiled a country-by-country profile of all 227 countries in the world, based on the best available statistics from the U.S. Census Bureau, United Nations agencies, country reports, and specialized surveys carried out by a variety of respected research organizations. For each country and each year, data were generated on the number of pregnancies that occurred, the number that ended in miscarriages and abortions, and the number carried to term. For each of these, the data sources were used to assess the number that resulted from unintended pregnancies, and the number of unintended pregnancies that resulted in the death of the mother.

Daulaire cited estimates by the World Health Organization and the World Bank that $3.00 per person per year would provide basic family planning, maternal and neonatal health care to women in developing countries. The package would include contraception, prenatal, delivery and post-natal care in addition to postpartum family planning and the promotion of condoms to prevent sexually transmitted infections.

"The simplest metric is in the number of women's lives saved as a result of access to appropriate health care services. What is not immediately apparent, however, is the social and economic benefit extended to her family, her community and society at large," Daulaire concluded.

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category: News from Other Sources : General Health News
contributed by Andrea Welch on 25 September 2002
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