Save the Mothers Fundby Hans van der Slikke, MD, OBGYN.net Editorial Advisor |
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http://www.obgyn.net/avtranscripts/savethemothersfund.htm |
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As well as the scientific content, the major issues of FIGO conferences are the social aspects of gynaecology: safe motherhood and violence against women. On each day of the congress, one or more key sessions were devoted to safe motherhood. Every minute somewhere in the world a mother dies as the result of pregnancy or childbirth. The major causes are haemorrhage, sepsis and unsafe abortion (Figure 1). In developing countries this means that 1 in every 48 pregnant women dies, whereas in developed countries the maternal mortality rate is 1 in 10,000. The death of a woman during childbirth has an enormous social and economic impact, not only on her often large number of surviving children, but also on the society in which she lives. Of all the major health indicators — life expectancy, infant mortality, etc. — only maternal mortality has not improved since 1960. FIGO’s mission is to promote the well-being of women and to raise the standard of practice in obstetrics and gynaecology, and the proceeds of the world congress are mainly used to fund these endeavours. The Save the Mothers Fund is FIGO’s first attempt to implement a project with the unique design of fostering co-operation between the obstetrics and gynaecology societies of developed and developing countries. It differs from other initiatives in that it is being carried out at a grassroots level, targeting the specific needs of each identified region and employing tactics as well as providing a structure to create positive changes. Monday morning’s Keynote Lecture was given by Dr Anne Tinker, Principal Health Specialist for the World Bank, who discussed women’s health issues in developing countries. Stating that ‘women’s poor health reflects their status in society as well as in their reproductive role’, she gave as examples the female genital mutilation in Africa and the poor treatment of women in South Asia due to the preference for sons and to the dowry system. Dr Tinker also remarked that the illegality of abortion in Latin America and the Middle East fosters unsafe abortion; whereas the poor availability of contraceptives in the former Soviet Union and Japan means that abortion in these countries is the principal method of birth regulation. Women’s status also affects access to health services: ‘Lack of mobility, decision-making power and income restrain women’s health service use. Prohibition against women seeking care from male doctors is another serious constraint’. Dr Tinker also illustrated the role of poverty: ‘The poorest women have much higher fertility and far fewer safe deliveries. They start having their families at younger ages: 40% of women in developing countries give birth before the age of 20’. Dr Tinker concluded by addressing the audience: ‘My plea today is that you, as obstetricians and gynaecologists, play a role in the solution by taking some crucial actions. Not only is women’s health a right and a humanitarian justice, it is critical to achieving broad social and economic development goals’. On Wednesday’s Watteville Lecture, the former president of FIGO, Professor Mahmoud F. Fathalla, shared his dream with the audience: ‘Imagine a world where motherhood is safe for all women.... You can make it happen’, he told the participants. In many countries maternal mortality is seen as a thing of the past, but Professor Fathalla reminded us that ‘In this world every minute 380 women become pregnant, 190 women face an unplanned and unwanted pregnancy, 110 women experience a pregnancy-related complication, 40 women have an unsafe abortion and one woman dies as a result of complications related to childbirth’. How can we achieve a safe road to motherhood for every woman? 1. Safe motherhood should be recognised as a human right: women deserve to be protected from complications. 2. A woman’s life should be considered worth saving. (Women are not dying from causes that cannot be treated. They die because the societies in which they live do not consider their lives worth the cost of saving.) 3. All women should have access to life-saving obstetric care. 4. A skilled birth attendant should attend all deliveries. 5. Motherhood should be a woman’s voluntary choice. 6. Making motherhood safe should be an international commitment. 7. Lack of resources is not an acceptable excuse for inaction. 8. We need to have obstetrics without frontiers. At present the world is evolving into having just one frontier: between the included and the excluded. 9. Safe motherhood should be recognised as a sensitive indicator of whether women enjoy their rightful status in society. To identify and implement the necessary changes in societies, FIGO has partnered the professional obstetrics and gynaecology societies in five developed countries with similar societies in eight developing countries (Figure 2): • Canada with Uganda, • Italy with Mozambique, • Sweden with Ethiopia, • United Kingdom with Pakistan, • USA with El Salvador, Guatemala, Honduras and Nicaragua. During the conference each of these societies presented its action plan in the FIGO booth in the exhibition area. The Canadian plan was set out as follows and can be viewed on The Society of Obstetricians and Gynecologists of Canada website http://www.sogc.org/SOGCnet/sogc_docs/intl/pregn_e.shtml: Main activities |
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