Preventing Maternal Death

Maureen, a maternal health advocate in Uganda, remembers losing her cousin—a young woman in her first year of university. During a secret abortion performed in haste, her intestines were accidentally pierced. She later developed diarrhea and intense stomach pain, but so great was her fear of being condemned for having the abortion, she did not tell anyone, even as her condition deteriorated.

Maureen’s cousin died after two unsuccessful surgeries, having informed the medical staff too late that she’d received an unsafe abortion.

Each year, nearly 300,000 women across the world die from pregnancy complications—including hemorrhaging, infections, and unsafe abortions. But it is not simply bad luck or a fact of life. In 90 percent of maternal mortality cases today, death is completely preventable.

The Center for Reproductive Rights and our partners have worked unrelentingly in courts and human rights bodies, including the United Nations Human Rights Council (UNHRC), to promote the view that preventable maternal mortality and morbidity is a human rights violation that governments must take measures to address.

These efforts have drawn global attention to the widespread discrimination and quality disparities in maternal health care and have played an integral role in the worldwide reduction of maternal deaths by 45 percent since 1990.

Since 2009, the UNHRC has passed five resolutions on preventable maternal death, each one moving incrementally toward implementing and enforcing human rights-based policies among member states. As a result of these resolutions, in 2012 the Office of the High Commissioner for Human Rights devised technical guidance on preventable maternal mortality and morbidity, which provides law and policymakers with the tools they need to guarantee women quality maternal health care in compliance with their international human rights obligations.  At the end of September, the Council passed it most recent resolution, calling on governments to implement the technical guidance and address the role that discrimination against women plays in the maternal mortalities.

“This latest resolution resoundingly affirms that states must adopt and implement concrete policies to improve maternal health,” says the Center’s global advocacy director, Rebecca Brown.

At the recent UNHRC session, Brown spoke at a side event that explored the role abortion stigma plays in women’s rights violations, including in reinforcing gender based stereotypes around motherhood and reproduction, and endangering women’s health and lives. The World Health Organization has repeatedly recognized the connection between restrictive abortion laws and elevated rates of maternal mortality. The technical guidance firmly recognizes that, in order to reduce maternal mortality rates, states must enable women to exercise their human rights, including by addressing the social determinants of health and guarantee women meaningful participation in the formulation of laws and policies surrounding their reproductive health. 

“States must take measures to address the multiple, intersecting causes of maternal mortality by enabling women to seek timely maternal health services, as well as elevating the status of women in society and guaranteeing their reproductive autonomy.”

Tackling maternal mortality means addressing root causes of these deaths which range broadly from inadequate transportation to poor maternal health care to cultural stigmas and racial biases. Too often, maternal mortality rates are directly linked to a woman’s social, economic, and cultural status.    

Generating a shift in international attitudes and perceptions of maternal death has been no small task. To document and highlight this historic shift, the Center has released a publication titled From Risk to Rights: Realizing States’ Obligations to Prevent and Address Maternal Mortality.

The publication, released during the UN Human Rights Council’s September session, examines the process by which maternal mortality and morbidity became recognized as a fundamental human rights violation and details many of the concrete measures implemented to realize the right to safe pregnancy and childbirth. It also provides a timeline of landmark events and recommendations for future action.

“Our efforts over the last 25 years have proven that we are capable of eradicating preventable maternal deaths, but we have a lot more work to do,” notes Brown.

“Maternal deaths still claim the lives of 800 women and girls every day. The only way governments can truly ensure the women in their countries stay healthy and safe during and after pregnancy is to ensure every woman has affordable access to quality maternal care and the full range of their sexual and reproductive rights are recognized in law and policy.”

This involves guaranteeing access to the full range of comprehensive reproductive health information and services, including comprehensive sexuality education, contraception, safe abortion, and post-abortion care on a basis of non-discrimination, without violence or coercion. Such services are particularly critical for women from marginalized communities—even in developed countries such as the United States and Australia—who remain at the greatest risk for pregnancy-related deaths and illnesses.