Safe motherhood: a basic right or a privilege of a few?
Maternal mortality rates in developing countries are higher than previously estimated and exceed 1000/100,000 live births in approximately 21 developing countries. While conditions of war increase maternal deaths, the leading direct causes are hemorrhage, sepsis, obstructed labor, eclampsia, and abortion. The World Health Organization (WHO) has prepared a video on the topic that states that nobody knows the extent of the problem of maternal mortality, nobody cares enough to ensure that women's needs are met, and nobody prepares, because not enough people understand the need to prepare for a healthy pregnancy and birth or how to respond to an obstetric emergency. The WHO has identified "gatekeepers" at every level to family planning, prenatal care, clean and safe delivery, and essential obstetric care, and it has created a series of midwifery education modules to promote safe motherhood. Conditions of poverty and low status for women are the prime indirect causes of maternal mortality and maternal morbidity (which is compounded in developing countries by inaccessible or unaffordable health care). Activities to improve this situation include the provision of obstetric supply packs to families, birth spacing programs, discouragement of female genital mutilation and early marriage, use of a picture card or drama and song to illustrate maternal complications, improved postabortion care, international study for midwife teachers, establishment of maternity waiting homes near hospitals, and use of the radio for health education.