Maternal Mortality and Morbidity

POVERTY AND THE RISK OF maternal morbidity and mortality are explicably linked. As noted by A. Germain, “one of the greatest disparities between rich and poor countries and, often, rich and poor people, is in maternal mortality.” Where countries have (and are willing) to spend the money in developing and maintaining effective environmental and healthcare systems, women's risk of becoming ill or dying during pregnancy declines.

However, “political and ideological roadblocks have obstructed progress on the nondisease elements of reproductive health: contraception, safe abortion, and comprehensive sexual education.” In other words, instead of providing access to and infrastructure for reproductive health, governments attempt to control childbearing as a means to reduce risks to women and [Page 688]children. The need to decrease maternal morbidity and mortality was recognized even before the Alma Ata Conference in 1978, is thoroughly discussed in Health for All documents for the years 2000 and 2001, and was made a major priority at the United Nations International Conference on Population and Development in 1995.

However, in 2000 there were 529,000 maternal deaths, with 13 countries (India, Nigeria, Pakistan, Democratic Republic of Congo, Ethiopia, United Republic of Tanzania, Afghanistan, Bangladesh, Angola, China, Kenya, Indonesia, and Uganda) accounting for 67 percent of these deaths. Since there has been continuous research and discussion about these problems for more than 30 years, why has there not been a significant positive change for women and their families with a reduction in maternal morbidity and mortality?

This article will provide definitions of, and examine the known underlying causes and risks for, maternal morbidity and mortality. In addition it will discuss the impact of these conditions on families and communities, review some of the data collection issues surrounding these conditions, and conclude with a consideration of the various recommended strategies for reducing maternal morbidity and mortality in this century.