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

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.