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Melinda Gates on 350,000 Childbirth Deaths: 'We Can Prevent Most'

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Ashley Judd. Former President Michelle Bachelet of Chile. Former Prime Minister Helen Clark of New Zealand. Former Irish President and former U.N. High Commissioner for Human Rights Mary Robinson. Journalist Christiane Amanpour. Model Christy Turlington. U.N. Secretary General Ban Ki Moon. Singer Annie Lennox. Philanthropist Melinda Gates.

All in Washington to discuss one thing: No woman should die giving life.

And yet they are dying, in droves. Some 350,000 women lose their lives each year giving birth or through complications of childbearing.

It's a number that the 3,500 attendees, from 140 countries, at the 2010 Women Deliver Conference this week in Washington, D.C., are challenging the international community to dramatically reduce by committing $12 billion in aid. "Three thousand people getting together to talk about this issue -- this has never happened before," said Jill Sheffield, president and founder of Women Deliver. "We had 80 parliamentarians. Nearly 50 ministers of different kinds. First ladies who were here. The biggest media group. Corporate involvement that is more engaged than ever."

According to the Guttmacher Institute, of the 123 million women birthing each year, only half are getting the full complement of prenatal, post-natal, and delivery care they need. "The direct health benefits of meeting the need for both family planning and maternal and newborn health services would be dramatic," Guttmacher materials distributed at the conference explained. "Unintended pregnancies would drop by more than two-thirds, from 75 million in 2008 to 22 million per year. Seventy percent of maternal deaths would be averted. . . . Forty-four percent of newborn deaths would be averted. . . . Unsafe abortions would decline by 73 percent."

According to the U.N. Population Fund, 20 million women have unsafe abortions each year. Of that number, 68,000 die annually from complications. Twenty times that number will have life-complicating consequences. Thirteen percent of maternal deaths are due to unsafe abortion. And 90 percent of abortion-related deaths and consequences could be avoided if women had greater access to contraception and education on contraception.

Thirty-five hundred women from 140 countries and enough star wattage to make the White House Correspondents' Association dinner seem tame. All focused on finding a solution and focusing international attention.

Organized around the premise of meeting the Millennium Development Goal Number 5 -- reducing by 75 percent the maternal mortality rates globally by 2015 -- the messages of the Women Deliver Conference centered on the theme: Invest in Women -- it pays.

Under that broad umbrella were three days packed with plenary sessions and break-out conversations, ranging from the macro -- stopping the needless deaths of women in childbirth, changing the way young people see family planning -- to the micro -- microbicides, new contraceptive devices, country-specific maternal and newborn health initiatives -- to the ultra specific: uterine prolapse in Nepal.

On the first day, Melinda Gates took the podium during lunch. Thousands of women, some in native dress, intricately, stiffly woven gowns from Ghana, jewel-toned saris, dozens upon dozens of T-shirts that read "Stand Up for African Mothers," gray-suited Washingtonians, sat with boxed lunches in the darkened auditorium.

"The death toll is so huge and has persisted for so long it's easy to think we're powerless," said Gates, her image projected onto three huge screens. "The truth is, we can prevent most of these deaths -- and at a stunningly low cost -- if we take action now." Health and international development experts estimate $12 billion is needed to address the problem globally.

To that end, the Gates Foundation, she said, was using the Women Deliver Conference to announce a new direction and a new pledge: $1.5 billion over the next five years in integrated women's health.

She said the grant will focus on everything from training workers in women's health and obstetrical care to contraception to nutrition to pre- and post-natal care in countries including India and Ethiopia.

Suddenly everyone was up, a thunderous, standing ovation. It was a recognition that integrated health is as important as any one specific goal.

Melinda Gates wrote later on Huffington Post: "I kept thinking about the overwhelming joy, hope, and optimism I felt when each of my three children was born. No matter who you are, no matter where you live, it is incredibly moving to hold a healthy baby in your arms. But tens of millions of women never get to experience that moment of beauty. For these women, childbirth is filled not with joy, but with dread, pain, and sorrow. They know they might die during delivery. If they survive, they are terrified their baby might die."

This personal message was not isolated. Something about women and sexuality and childbearing created a strange three-day share-fest among the women in the gleaming glass and steel Washington Convention Center. Supermodel-turned-advocate Christy Turlington, presenting her documentary, "No Woman, No Cry," said her interest in preventable maternal deaths came from her own potentially life-threatening hemorrhage after the birth of her first child.

At a chat chaired by Arianna Huffington, luminaries Ashley Judd, Helen Clark, Michelle Bachelet and Valerie Jarrett from the Obama administration talked about affirmation and birth stories. It was a lighter moment in a set of days that had few breaks from intensity. But it was not all rosy. Arianna Huffington casually mentioned she had lost a child in childbirth. Michelle Bachelet said: "We are great women, but we are not superwomen. You have to prioritize." And Helen Clark admitted when she ran for office in New Zealand: "My voice was too low, my teeth were crooked. I had no children, and that was a source of endless gossip."

Maybe the crowd needed the break from the stories of women who died in childbirth, of lost children, of women who became incontinent from labors that never progressed.

U.N. Secretary General Ban Ki Moon movingly described how as a child he saw the empty rubber shoes of women who were about to go into labor. The women would glance at their shoes, his mother told him, because they wondered if they would ever step back into them again. Birthing in rural Korea in the mid-20th century was that dangerous. As dangerous as it is now in the developing world.

"I remember the first time I heard the phrase 'women's rights are human rights,'" former President Michelle Bachelet of Chile said at the opening session, referencing the 1995 Beijing Women's Conference. The uber-low-key Bachelet, who came to Washington with no entourage and slept at the home of friends, noted that having served as her country's defense minister at one time, "I know something about waging a campaign . . . the battle for women's health is a worldwide struggle and the enemy is political indifference."

It was not all love. Abortion was, as always, an issue of contention. There were those who felt that the abortion question should have been highlighted. Activists at International Planned Parenthood and IPAS underscored that the conversation needn't be simply about financing abortion, but also about preventing abortion through contraception and education. And that anti-abortion activists and advocates needed to realize post-abortion care is maternal health, too. "We're stigmatizing the conversation," said one. "It is easier to address than hemorrhage, which requires a blood transfusion, or sepsis or eclampsia," said another.

The conversation about abortion was also directed at Canada, set to hold the G8/G20 summit later this month. Though Prime Minister Stephen Harper has maternal health on the agenda, abortion -- and financing for abortion -- is explicitly not. "There is nothing pro-life about denying access to abortion," said Dr. Keith Martin, a physician and member of the Canadian Parliament. "How can we sit here and deny women rights we have in the West? It's offensive in the extreme. "

Similarly, midwives expressed frustration that more attention wasn't paid to their work and the possibility of training more midwives on the ground in developing nations. "It's all good to say you have to have emergency obstetric care," said Louise Silverton, of the Royal College of Midwives, a group setting global standards for midwifery. "We need to train and support midwives in rural areas."

Finally, there was a discussion on how to engage young people in a conversation about family planning, since family planning has no resonance with many women in their 20s.

"Maternal mortality is the highest cause of deaths of girls 15-19 globally," said Jill Sheffield, the organizer. "Too many girls are getting pregnant." One suggestion was that the United States could learn from other developed nations in the arena of sex education, and recognize that the word sex is a lot more appealing than family to women under 25.
Filed Under: Woman Up

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Nobody in human history has given more than the Gates family, from Aids to Education they have been at the forefront of helping others

June 15 2010 at 12:00 PM Report abuse +2 rate up rate down Reply

It should be evident to anyone reading this article that abortion must remain safe and legal in the United States. In addition, our maternal death rate in very high for a civilized country. This is because of the profit motive. We focus our efforts on dangerous and unnecessary caesarian sections instead of simple, appropriate natural births with midwives attending. Let's take the birth process back from doctors and return it to women.

June 12 2010 at 9:19 PM Report abuse +1 rate up rate down Reply
1 reply to kctaxlady's comment

Well said. By approaching birth from a medical and emergency point of view, we are getting corresponding results. It will improve not just maternal mortality statistics, but fetal mortality statistics as well (which are equally abysmal).

June 13 2010 at 10:16 AM Report abuse +1 rate up rate down Reply

How about helping American kids, whohave telephones stuck in their ears everytime you look at them. I am so appallled at new phones and the money you make off of families as most do not have money to spend now on anything but food and shelter. Not phones. I love both of you kids and I am 75 so I see how the kids are begging for the new things. I just wish you would use better judgement with your money by helping the orphans in this country as we need an orpanage for thme.

June 12 2010 at 8:08 PM Report abuse +2 rate up rate down Reply

It is difficult to get these funds to the people it is intended for. I went to Haiti a year ago (before the quake),on a missions trip to build a school. The Haitian government builds no schools. We also arranged for a ship container full of shoes to arrive so we could take it to a remote village. When the container arrived it was quickly confiscated (stolen) by the Haitian government and sold in the Dominican. We do not plan to go back.

June 12 2010 at 1:33 PM Report abuse +5 rate up rate down Reply

It is more than lack of care... it is also methodology. America's maternal AND infant death rate correspond directly to the amount of technology and the high numbers of cesareans forced into a process that does not need to be manipulated as much as it is. It traces back to a lot of CYA in a hospital... for the insurance guys. Childbirth, as life, has a small amount of danger that is part of life. Yet, the USA's numbers continue to climb. We need to concentrate on giving every woman of any nation that one-on-one eye-to-eye, hand-on-belly care that is the key to safer birth. When that is accomplished, the needs of each woman are revealed, and they can be addressed in a unique each woman and pregnancy is unique. A cookie cutter approach just is not and will not work. More machines and drugs and invasive techniques are not the answer. Pregnancy is not an illness, but the more it is approached as an illness, the more results we get that resemble an illness. It is a process, an extremely personal and private process. We are way off track in how it is handled, and until we can focus back on what it REALLY is, it will not come back on course.

June 12 2010 at 12:05 PM Report abuse rate up rate down Reply

And to avoid adding to the THREEHUNDRED MILLION murdered, not for "health reasons" but for sheer selfishness, what do you suggest?

June 11 2010 at 8:18 PM Report abuse +3 rate up rate down Reply
1 reply to Luette's comment


June 11 2010 at 10:13 PM Report abuse -4 rate up rate down Reply

Agree with additional maternal care, midwives, etc. but re abortion - What happened to the argugment that if we only legalized abortion, it would pretty much end women's deaths for unsafe ones??? I was a counselor at a pregnancy crisis clinic and a mom of 5 and know all about this subject. Some had to deal with women with postabortion traumas. We were upset how this was not talked about and known...from the proabortion crowd. So I appreciate that part in this article. I'm all for education about contraception, medical care, etc. but I must say I don't agree how that 90% could be stopped with that. That's naive and refusal to face reality/facts. That's not the root problem. My experience has been that even with the education, it will still happen because of human nature. It's the lack of will to practice morals and/or disrespect for God, life (when not a rape or something of course)....scared they will lose their boyfriends/husbands if they don't have sex and/or the fathers telling them to get abortions (a lot of that). More concern for that than the life of their "developing human being". That was our real-life experience and common sense. No, legalizing it does not only increases them. I disagree passionately that it's not prolife to "deny" abortions - that's ridiculous and nonsensical. Most prolifers will agree it's different when the life of the mother is in danger - but that is RARE.

June 11 2010 at 7:32 PM Report abuse rate up rate down Reply

The United States has the highest rate of maternal death in the industrialized world because of the pathetically poor, Third World, insurance run and insurance rationed health care system which gives the United States the worst health care in the industrialized world.

June 11 2010 at 7:29 PM Report abuse -6 rate up rate down Reply
4 replies to John's comment

It's interesting how many causes there are which need to be addressed by the global community. I, myself, would probably not support this initiative because according to the numbers given in the article, less than one-half of one percent of women die during birthing each year. It is not possible to achieve 100% safety for every woman in the world giving birth, and a 0.3% mortality rate is just about as low as the percentage can get and still be realistic from a medical standpoint.

I also disagree with deaths from botched/illegal/unsanitary abortions being included in the mortality rate of mothers during childbirth. Abortion is an elective medical procedure, it is NOT a natural consequence of the birthing process. In fact, removing the number of women who die from abortion complications from the mortality rate for birthing mothers, the number of mothers who die from birthing complications drops to 0.23%, or less than one-quarter of one percent.

Of course, today I don't think anything makes a difference in this world. If I did, though, I would have to wonder what needed to be done to support unwanted pregnancy prevention... in every country in the world. Even this one.

June 11 2010 at 6:53 PM Report abuse rate up rate down Reply

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