For the first time in decades, researchers are reporting a significant drop in the number of women worldwide dying each year from complications related to pregnancy and childbirth, the New York Times reports.
Published in the medical journal The Lancet, the findings challenge the prevailing view of maternal mortality as an intractable problem. According to the report, Maternal Mortality for 181 countries, 1980-2008: A Systematic Analysis of Progress Towards Millennium Development Goal 5 (15 pages, PDF), improvements can be traced to lower pregnancy rates in some countries; higher incomes, which lead to improvements in nutrition and greater access to health care; more education for women; and an increase in the availability of "skilled attendants" during childbirth. At the same time, the number of pregnant women who died from AIDS rose to 60,000 in 2008 and was a significant factor in the increase in maternal mortality in eastern and southern Africa.
Results in poor countries with high maternal death rates over time also varied considerably. For instance, from 1990 to 2008, the maternal death rate dropped by 8.8 percent a year in the Maldives but rose 5.5 percent in Zimbabwe. Sub-Saharan Africa had the highest maternal death rates, while India, Nigeria, Pakistan, Afghanistan, Ethiopia, and the Democratic Republic of Congo accounted for more than half of all maternal deaths in 2008.
Positive long-term trends notwithstanding, some women's health advocates tried to delay publication of the study, which was funded by the Bill & Melinda Gates Foundation, out of concern that the good news would undermine the urgency of their cause. "People who have spent many years committed to the issue of maternal health were understandably worried that these figures could divert attention from an issue they care passionately about," said Dr. Richard Horton, editor of The Lancet. "My view is that actually these numbers help their cause, not hinder it."
Indeed, the findings were hailed by some advocates as proof that their work was paying dividends. "For twenty years, the safe motherhood movement has been conveying an impression of no progress," said Flavia Bustreo, director of the Partnership for Maternal, Newborn, and Child Health, an affiliate of the World Health Organization. "To hear confirmation of improvements is good news. To us, the good news will maintain the interest of investors. If you don't show results, that's the worst position you can be in. The evidence and scientific truths have to be put in the open and discussed."