Developing World: Maternal and Neonatal Mortality

Baroness Kinnock of Holyhead Excerpts

Thursday 15th January 2015 Lords Chamber

[Baroness Kinnock of Holyhead (Lab)]

My Lords, I, too, thank the noble Baroness, Lady Hayman, for introducing this debate and for doing so in such a compelling and expert way.

In large parts of the world, poverty means that great numbers of women die from a lack of family planning, an inability to negotiate the number and spacing of children, the lack of money to pay for skilled birth attendants or emergency obstetric care, and violence. In spite of some welcome progress, it is clear that MDG 5, on reducing maternal mortality and achieving universal access to reproductive health, is far from being fulfilled. However, as affirmed by the UN Commission on the Status of Women, the elimination of preventable maternal mortality is possible in the next decade but it will, clearly, require a major scaling-up of our efforts. Does the Minister agree that sexual and reproductive healthcare for women and girls should be a specific priority, separated from maternal health, so that its allocation and impact can be properly measured? Is the Minister aware that around only 1% of ODA is currently allocated to family planning?

DfID has also committed to,

“enable 10 million more women to access family planning (of which 1 million will be girls aged 15-19)”.

How confident is the Minister that this objective can be met, since only 4,966,000 have been reached to date? Does the Minister agree that, as DfID spending on humanitarian assistance is increasing, it is vital that a comprehensive package is offered in emergency settings, such as conflicts and disasters, and that this should include access to sexual and reproductive health?

The UN high-level panel established to prepare the post-2015 agenda for action estimates that 800 women die every day from complications related to pregnancy and childbirth and, according to the WHO, 99% of those maternal deaths occur in developing countries. In addition, medical experts testify that, globally, every year there are about 80 million unplanned pregnancies and 20 million unsafe abortions with the result that, as Marie Stopes International points out:

“Worldwide, one woman dies every 11 minutes from an unsafe abortion”.

Unsafe abortion is a major cause of maternal mortality and remains a major public health and human rights concern. Being able to make an informed choice and take control of your own reproductive health is surely a basic right. Does the Minister agree with the view that Governments and donors need to prioritise what women want, rather than what they feel most comfortable with doing and providing? Such a change is urgent. I remember talking to Beth outside her home in rural Tanzania. Such were the perils of childbirth that before she went into labour she would say goodbye to her children. Giving life should surely not mean taking such a risk.

A post-2015 assessment says that aiming to reduce newborn mortality by 70% will prevent 2 million child deaths every year. Such evidence highlights the urgent need to provide expectant mothers with nutrients, protection against disease, nursing care, clean water and hygiene facilities. All these initiatives can save precious lives and are taken for granted in the developed world. No girl should die giving birth and no child should die because its mother is too young. Each year around 1 million babies born to adolescent girls die before their first birthday.

These issues go beyond family planning. Campaigns and condom distribution are irrelevant to women and girls who simply do not have the power to make the decisions. A country’s current status and future prospects are clearly illuminated by examining, for instance, the lifetime risk of maternal death, the percentage of women using modern contraceptives, women’s literacy rate, their participation in national growth and the enrolment of girls in school.

The reality is that gender inequality remains a major propellant of poverty and women’s marginalisation, and a basic cause of underdevelopment. Faced with that reality, it is clear that little will change until the underlying root causes of discrimination are plainly and publicly identified as gender inequality and pervasive, discriminatory norms. Religious, cultural and social barriers impose overt discrimination that stands in the way of women’s freedom to choose.

One hundred and ninety-three Governments are currently gearing up for the UN discussion, at September’s annual meeting, on priorities for the next decade and a half. Currently, there are 17 goals and 169 targets. However, we can safely say that there will be a stand-alone goal on gender equality, women’s rights and empowerment. This will include universal access to sexual and reproductive health, and rights to be mainstreamed across all other goals. The task is to prevent an estimated 640,000 newborn deaths and 150,000 maternal deaths each year, which will result in 600,000 children having to grow up without a mother. When motherless children are 10 times more likely to die within two years of their mother’s death, the urgency is graphically obvious.

To achieve such advances we will indeed need political leadership. When fundamental rights are upheld, women, girls and young people can thrive. They can gain education, get better jobs with better wages and therefore reach their full potential. That objective is essential and, I believe, achievable. It will serve every interest. It must gain active support. The British Government have a duty to take the lead in that mission.