Like child mortality in many countries around Asia, maternal
mortality rates remain staggeringly high, despite the global commitment
of reducing maternal mortality
ratios by three-quarters.
With progress one-fifth of what it needs to be, ActionAid reports that maternal mortality is
the Millennium Development
Goal on which the
least progress has been made. Not only does it appear that women's right
to survival is a neglected concern around the globe, but apparently
it is also forgotten amongst the other millennium targets.
On September 24, 2008, world leaders will meet at a High-Level Event on the Millennium Development Goals to discuss progress to date and what programs need to be implemented to bridge the MDG gap as we rapidly approach 2015. This meeting presents a decisive opportunity to ensure that the limited progress on maternal mortality is at the center of the dialogue. Interestingly, Africa features significantly amongst the partnership events being organized in conjunction with the High-Level Event. Yet many of the counties in South-East Asia have similarly seen little improvement in their maternal morality ratios. With the World Health Organization (WHO) stating that maternal mortality in South-East Asia contributes to 40% of global deaths, maternal mortality in the region needs to be put back on the discussion table. 2005 maternal mortality ratio estimates released by WHO were as high as 540 maternal deaths per 100,000 lives births for Cambodia, 420 for Indonesia and 230 for the Philippines as compared to 14 for the Republic of Korea or 11 for the United States.
On World Population
Day in July of this year, UNFPA noted that three basic interventions
are necessary if the world is to improve maternal health: skilled birth
attendants, access to emergency obstetric care and family planning.
On this occasion, the Secretary-General reiterated the global commitments
made in Cairo in 1994 at the International Conference
on Population and Development
on access to family planning information and noted its relationship
to combating maternal mortality. Yet, years after the right to decide
the number and spacing of one's children has become a standard call-cry
for reproductive rights activists, many countries in Asia continue to
fail to guarantee access to all forms of modern contraceptives.
The interrelationship between unwanted pregnancies that result from lack of family planning, unsafe abortion and high rates of maternal death is unquestionable. It is estimated that unsafe abortion, what has been deemed by WHO as the silent, but preventable, pandemic, contributes to 19% of maternal deaths in South-East Asia in any one year. In the Philippines, where abortion is illegal and remains a taboo subject, it is estimated that up to 800 women die each year as a result of unsafe abortions, not to mention abortion-related complications and their impact on women, their families and the country's health system. In many countries in the region where abortion remains illegal, such as Indonesia, Laos and Myanmar, activists continue to advocate for abortion reform, to improve access to safe abortion, particularly for marginalized or poor women.
A change in abortion laws alone is not the solution. In Cambodia, despite the legalization of abortion in 1997 on broad grounds, many women remain unaware of the change in law and still undergo terminations carried out by unskilled providers. Education and awareness raising is a key element to addressing misconceptions about the law, misconceptions that make women vulnerable to bad care, bribery and corruption, or no care at all. This is particularly true for adolescents and other unmarried women, where cultural barriers and taboos about sex outside of marriage exacerbate this vulnerability to seeking clandestine abortions. The need to address this gap in knowledge about the legality of abortion should be considered by other legally permissive countries in the region like China, DPR Korea, Japan, Mongolia and Vietnam.
The importance of concerted efforts by countries to stop preventable maternal deaths has clearly been endorsed by the world community through the MDGs. Whether abortion is currently legal or illegal, governments must develop an effective strategy to ensure women's right to access legal abortion procedures by skilled individuals under safe conditions. Such much needed change will move many of the countries in the region much closer to reaching their MDG target and tackling their maternal death pandemics. Such progress would also reflect a revaluing of women's lives and their human right to survive pregnancy.
