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Over half a million women die each year due to complications during pregnancy and birth.
The vast majority of these deaths are preventable. At the Millennium Summit in 2! States
resolved to reduce maternal mortality by three "uarters by the year 2#$. This commitment
is encapsulated in the Millennium %evelopment &oals! which derive from the Millennium
Summit commitments! and which have come to play a de'ning role in international
development e(orts. &oal $ is a commitment to improve maternal health) the reduction of
maternal mortality is an outcome chosen to assess progress in this regard.This resolve by
States to reduce maternal mortality is not new. *owever! never before has the issue been
given such prominence on the international development agenda. %espite longstanding
international commitments to reducing maternal mortality! so far progress has been
disappointing.
This brie'ng illustrates how human rights + and the right to the highest attainable standard
of health ,-right to health./ in particular + can contribute new impetus! framewor0s and
strategies for reducing maternal mortality. 1n recent years! there has been increased
recognition that reducing maternal mortality is not just an issue of development! but also an
issue of human rights.2reventable maternal mortality occurs where there is a failure to give
e(ect to the rights of women to health!e"uality and non3discrimination. 2reventable
maternal mortality also often represents a violation of a woman4s right to life.Maternal
health has a particularly close relationship with the right to the highest attainable standard
of health. This fundamental human right is recognised in the 1nternational 5ovenant on
Economic! Social and 5ultural 6ights! as well as other international human rights treaties.
The right to health includes entitlements to goods and services! including se7ual and
reproductive health care and information. 1t re"uires action to brea0 down political!
economic! social and cultural barriers that women face in accessing the interventions that
can prevent maternal mortality. 1t re"uires participation by sta0eholders in policy and service
development. And it re"uires accountability for maternal mortality. 1n short! the promotion
and protection of the right to health demands actions that lead to a signi'cant and sustained
reduction inmaternal mortality.This brie'ng introduces the contribution of the right to the
highest attainable standard of health to reducing maternal mortality. This contribution is
twofold. The right to health provides)
a/ A framewor0 for designing e(ective policies to reduce maternal mortality8 b/ Tools and
strategies for advocacy and accountability for reducing maternal mortality.
Entitlements and obligations arising from the right to health underpin both of these
contributions and are described in the 'rst chapter of this brie'ng. 2olicy ma0ing and the
role of traditional human rights techni"ues are e7plored in the second and third chapters
respectively. This brie'ng indicates 0ey contributions that the right to health can ma0e in the
conte7t of policy ma0ing and through the human rights community4s traditional techni"ues!
such as letter writing campaigns!litigation and advocacy. 1t also indicates 0ey actions that
may be re"uired by policy ma0ers and the human rights community. The brie'ng does not!
however! provide detailed guidance on to how to operationali9e the right to health in the
conte7t of maternal mortality.The right to health should lie at the heart of the human rights
response to maternal mortality. The right to health is intimately connected to other human
rights+ including the rights to life and education + which are also highly relevant in the
struggle against maternal mortality. :hile this brie'ng focuses on the right to health! it also
gives some attention to the contribution of other human rights.
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*ere4s why it4s important to reach the maternal health M%&)
#. Millions of mothers are dying
According to the United Nations Population Fund (UNFPA), the global maternal
death rate has remained stagnant o!er the past decade because maternal health
is the least funded of all the Millennium %evelopment goals! and is the one that the world is
farthest behind in reaching. ;< Secretary3&eneral =an >i3moon has termed the continued
prevalence of women su(ering pregnancy3related deaths a -scandal.. :hile the number of
child deaths fell from around #? million in #@@ to less than # million in 2A! the number
of maternal mortalities has remained virtually static.
-This is an unacceptable situation! and we are all responsible for it because it has never
been funded correctly!. says %r. Buc de =ernis! senior maternal health advisor for the ;<C2A.
2. %eath in childbirth can be prevented
Although the number of women who su(er pregnancy3related deaths in 5anada is among
the world4s lowest! it is a real ris0 for women in poor countries who do not have access to
reproductive health care. "!er# minute a $oman dies in childbirth some$here
around the $orld%more than hal& a million mothers are lost e!er# #ear':omen in
developing countries! especially in sub3Saharan Africa! are most at ris0Done in seven
women in <iger will die due to complications from pregnancy or childbirth.
The main reason for these shoc0ing statistics) too man# $omen are gi!ing birth
$ithout a trained or s(illed attendant who is capable of alleviating haemorrhaging ,the
leading cause of death/ by providing the hormone o7ytocin! preventing an obstructed labour
by delivering by 5aesarean! or providing basic post3partum shots for tetanus and other
infectious diseases. :ith the proper care and supplies! these complications are highly
treatableD5anadian women are also at ris0 for labour complications! but access to care
saves more lives here.
?. 5aring for women saves children
1mproving the chances of survival and the overall health for mothers also means giving their
children a greater chance at living.
-And we4re not just tal0ing about their newborn babiesDresearch shows that when mothers
die! the other children in the family have a much greater li0elihood of dying!.says Susan
:hite! E7ecutive %irector of the 5anadian :omen4s *ealth <etwor0. 1n fact! according to the
;<! children $hose mothers died in birth are ten times more li(el# to die
prematurel#' -The bottom line is that saving mothers4 lives also saves children4s lives!. she
says.
E. Cunding can help treat birth3related injuries
For e!er# $oman $ho dies in childbirth, another 20)about 10 million e!er# #ear)
$ill su*er &rom related in+uries! infections and diseases that saddle them with a lifetime
of pain! su(ering and humiliation.
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One of the most horri'c injuries) 'stula! which occurs when the pressure from an obstructed
birth leaves a hole between the vagina and the bladder or rectum. These holes can be
surgically repaired! but in poor countries women are often left untreated! and have to su(er
the pain and humiliation of losing the ability to control the Fow of e7crement from their
bodies for the rest of their lives.
,here is intense stigmatisation &or these $omen, $ho are o&ten totall#
abandoned b# their partners and their &amilies, says de =ernis. -1t is very common
for us to visit remote communities and discover women who have lea0ed urine or feces for
years and years8 nobody ever informed them that treatment was possible. 1t is a terrible
situation..
$. :omen are dying from unsafe abortions
The 5anadian government has stated that it will not fund programs that provide access to
abortions in developing countries as part of its aid pac0age.
*owever! many e7perts on maternal health say it4s an issue that needs to be addressed. -1t
is important to note that many of the countries that have the highest number of maternal
deaths have limited access to abortion!. says :hite. -ore than 1. million unsa&e
abortions ta(e place e!er# #ear, and more than /0,000 $omen die annuall# as a
resultDand neither 'gure has changed signi'cantly in a decade! according to the ;<C2A.
-:e are very an7ious about these declarations from 5anadian politicians!. says the ;<4s de
=ernis. -1t is very important to understand that maternal mortality cannot be reduced
without improving access to safe abortions! when legal. :e cannot pretend to be interested
in maternal health without addressing this issue..
A. 1t will improve women4s lives
-This is also a gender issueDit is only women who deal with the real burden of reproduction!
only women who face death and disability from childbearing!. says de =ernis. -This really is
an issue of human rights..
;ltimately! improving access to contraception! safe abortions! and the ability to choose
when and how many children to have means improving education and social standing for
women overall. -The fact remains that women4s needs are not as highly valued as they
should be!. says :hite. ,he bigger issue ultimatel# is empo$erment o& $omen'
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,0" 1-P23,AN4" 2F 52-"N67 0"A8,0
A womanGs health is her total well3being! not determined solely by biological factors and
reproduction! but also by e(ects of wor0 load! nutrition! stress! war and migration! among
othersH
:omenGs health issues have attained higher international visibility and renewed political
commitment in recent decades. :hile targeted policies and programs have enabled women
to lead healthier lives! signi'cant gender3based health disparities remain in many countries.
:ith limited access to education or employment! high illiteracy rates and increasing poverty
levels are ma0ing health improvements for women e7ceedingly diIcult.
*ealth3related challenges continue. Many of the modest gains in womenGs health reali9ed in
recent decades are now threatened or have been reversed due to war! economic instability
and the *1JKA1%S pandemic. =asic health care! family planning and obstetric services are
essential for women H yet they remain unavailable to millions. &ender3e"uitable approaches
to health are needed to enable womenGs full participation in the planning and delivery of
health services.
The health of families and communities are tied to the health of women H the illness or
death of a woman has serious and far3reaching conse"uences for the health of her children!
family and community.
The slogan! H*ealthy :omen! *ealthy :orldH embodies the fact that as custodians of family
health! women play a critical role in maintaining the health and well being of their
communities.
Maternal conditions are leading causes of death and disability among women. More than @@
percent of the estimated $?A! maternal deaths each year occur in the developing world.
Every year! about # million women endure life3threatening complications during pregnancy
and childbirth! sometimes leading to long term disability.
&lobally! women comprise half of the adults living with *1JKA1%S H in sub3Saharan Africa! the
proportion rises to A# percent. A woman a(ected by *1JKA1%S is plunged further into
poverty! losing the ability to provide for herself and her children.
Early and unwanted childbearing! *1J and other se7ually transmitted infections! and
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pregnancy3related illnesses and deaths account for a signi'cant proportion of the burden of
illness e7perienced by women H especially in low3income countries.
<early all maternal deaths are preventable through timely prenatal and postnatal care!
s0illed birth attendance during delivery and the availability of emergency care to deal with
complications. The health bene'ts of spacing and limiting births for mothers and children
with family planning services are well 0nown.
Millennium %evelopment &oal $ focuses on reducing the maternal mortality ratio ,MM6/ by
L$ percent between #@@ and 2#$ and ensuring universal access to reproductive health by
2#$.
1nternational funding from public and private donors and other non3governmental
organi9ations accounts for only #$ percent of the e7penditures on reproductive health and
family planning activities in developing countries. The majority of spending comes from
within the countries themselves! with more than half coming from consumersG poc0ets.

www.globalhealth.org
:e 0now how to prevent or treat most of the causes of child and maternal deaths.*ealth
care during pregnancy! childbirth and the 'rst wee0s of life could prevent most maternal
deaths and newborn deaths ,which account for over E per cent of child deaths/.
%iarrhoea! pneumonia! and malaria are the leading causes of child deaths after the 'rst
month of life.
:omen and children are not dying because we do not 0now how to save them! but because
these solutions are not available to them.
M The conditions of daily life are the root cause of these deaths
The vast majority of children and women could be saved if all women were educated! all
families could earn an
ade"uate income! and everyone had clean water! ade"uate food! decent housing! good
hygiene and sanitation!
immuni9ations and healthcare. <ot only are these basic needs + they are human rights.
M 5hild and maternal health is a barometer for how well our communities! country and the
world are doing.
5hild and maternal deaths reFect e7isting paths of ine"uality. :omen and children in rich
countries rarely die in
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childbirth or from diarrhoea! pneumonia! and malaria. The vast majority of child and
maternal deaths happen in
the developing world. *owever! child and maternal deaths + and the ine"ualities behind
them + are not just an
issue in the developing world. =oth in the developing or developed world! some children and
women
in the same country are more li0ely to die than others. Biving in a rural area! being from a
poor
household! or belonging to a group that
faces discrimination all increase the
li0elihood that
a woman or child will get sic0 or die.
M 1mproving child and maternal healthis
good for societies
1nvesting in child and maternal health
increases productivity and prosperity for
families and society as a whole. 1t
ensures that women and children can live
their rights and reach their fullest
potential.