Childbirth 300 times riskier in poor countries than in rich: UNICEF

Posted at 01/15/2009 8:44 PM | Updated as of 01/22/2009 6:28 PM

JOHANNESBURG - Women living in poor countries are 300 times more likely to die during pregnancy or childbirth than if they lived in rich countries, UNICEF said in a report released Thursday in Johannesburg.

"The divide between industrialised countries and developing regions -- particularly the least developed countries -- is perhaps greater on maternal mortality than on almost any other issue," the UN Children's Fund said.

"No other mortality rate is so unequal," it added.

The lifetime risk of a maternal death for a woman is one in seven in Niger, compared to one in 47,600 in Iceland, the agency said in its annual report on the world's children, this year focusing on health for mothers and newborns.

"It is such a staggering figure," UNICEF executive director Ann Veneman told AFP in an interview.

On average, 1,500 women die every day during pregnancy or childbirth, or about half a million per year, with 95 percent of them in Africa or Asia. India alone accounts for 22 percent of the global total.

One quarter of these women die from post-partum haemorrhage, 15 percent from infections, 13 percent from complication in an abortion, 12 percent from eclampsia (a metabolism problem that causes hypertension and convulsions) and eight percent from obstructed labour.

"For each woman that dies, you've got 20 others who get serious complications resulting in lasting consequences," such as fistules, which damage the reproductive organs and is debilitating for a lifetime, Veneman said.

Maternal deaths also affect the mortality rate among newborns, especially when infants are at greatest risk in the first 28 days of life.

About 9.2 million children under five die every year, Veneman said.

"Forty percent die in their first 28 days. A lot of that is linked to the mother's health," she added.

The report found that babies whose mother died during the first six weeks of their life are much more likely to die before their second birthday than infants whose mother survives.

In an extreme case, 75 percent of babies in Afghanistan whose mothers die in childbirth do not live more than one month, it added.

UNICEF said that about 80 percent of maternal deaths could be prevented if women had access to primary health care or basic obstetrics.

The agency's report calls for systems of lifelong care for women and greater access to education for girls, as well as fighting gender discrimination.

"Saving the lives of mothers and their newborns requires more than just medical intervention," Veneman said.

"Educating girls is pivotal to improving maternal and neonatal health and also benefits families and societies."

Training also needs to be provided to health workers and midwives to improve the care that they provide, she added.

The report noted that educated women generally have children later in life. The risk of dying during pregnancy is five times higher for women under 15 than for women older than 20, it added.

"Many women in developing countries have no say in their own health-care needs," the report said, noting that in Mali, Burkina Faso and Nigeria, more than 70 percent of women said their husbands made their medical decisions for them.


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