Developing World: Maternal and Neonatal Mortality

Baroness Tonge Excerpts

Thursday 15th January 2015 Lords Chamber

[Baroness Tonge (Ind LD)]

My Lords, I, too, thank the noble Baroness, Lady Hayman, for bringing this matter to the attention of the House. As chair of the All-Party Parliamentary Group on Population, Development and Reproductive Health and president of the European forum of the same name, it is a subject that has occupied most of my waking hours in the last few years. Indeed, sexual and reproductive health occupied the whole of my professional life before I was elected to the other place.

I am constantly dismayed when I talk to colleagues about maternal mortality and family sizes. I get back the same old mantra. “Oh”, they say, “we can’t do anything about it—people in developing countries need big families because they have to have people to look after them in their old age and they need people to work in the fields. They’ve got to have big families—you mustn’t prevent them from doing that”. We have all been working hard in this Government, and in DfID in particular, to convince those Members that that is no longer the truth.

We have heard a lot of statistics, and I welcome their repetition; we should have them fixed in our head. But in fact maternal mortality is reducing—there is some good news. It has reduced by some 50% in the past 20 years; now around 250,000 women die per annum. That is still far too many, but it is reducing. With that figure goes the estimate that 2 million neonatal deaths occur per annum—and we know that they are linked.

We must also remember, as all Members have pointed out, that it is not just maternal deaths. They hide the fact that maternal morbidity and terrible conditions after childbirth, such as fistula—of which I know the noble Lord, Lord Patel, has had such experience and on which he has done so much incredible work—are also very important and account for millions of women being unable to take proper part in family life and look after their families properly because of childbirth. All are due to lack of proper medical and obstetric care and to other factors such as too-early marriage, child marriage, forced marriage, violence in marriage—but most of all, in my view, they are due to a lack of family planning, which enables women to control their own bodies and voluntarily space the number of children that they have.

We know that more than 2 million women in developing countries would use birth control entirely voluntarily if they had access to it. That is a fact. It has been disregarded in the past, but thanks to the efforts of parliamentarians here, Governments such as our own, and the Bill and Melinda Gates Foundation, a great effort is now being made to get family planning supplies out to those women who need them.

In 2012, our own Government—and I am very proud to mention and applaud this—held a great family planning summit. Pledges were made from all over the world and progress has been made. Since then, 8.4 million more women are now able to control the number of children that they have: that is in a report from the organisation Family Planning 2020, which was set up to monitor the pledges given at the summit and see that they were being delivered. This is all happening despite tradition, despite their religion, despite all the excuses given in the past—especially the one that we need children to look after us in or old age. I am constantly telling my children that.

I hope that our colleagues in both Houses will take note and realise that maternal health—and family planning in particular—is the way to sustainable develop -ment. The World Bank, no less, has pointed out that sustainable development and a steady rise in a country’s GNP follow a reduction in family size or fertility rate in that country. We know now that it is not the other way around. Sexual and reproductive health and rights, including family planning, are essential for sustainable development. We are pretty sure, too, that fewer people will mean less environmental degradation; my all-party group is doing an investigation into this subject at the moment.

There are other advantages for us, too, when this happens. Less international aid will be required in the long term; there will be bigger markets for our goods, if that interests noble Lords; and—dare I say it—there will be less migration from those countries for a better life in the West. Let us say that loud and clear: if they do not listen to our arguments on maternal health and reproductive health and rights, tell them that; tell that to UKIP and tell those people who disregard the importance of international development.

I am still concerned that this message is not being taken as seriously as it should be by the United Nations body deciding on the action needed after 2015, as was touched upon by the noble Baroness, Lady Kinnock. At that time, the millennium development goals should have been achieved. We know that MDG 5 on maternal mortality will not be achieved: there is not a hope.

The European forum of which I am the president—I want to tell your Lordships about this—has Members of Parliament from 25 countries in Europe and beyond. It includes members from Russia and Turkey; it is not just the European Union. We liaise with, and have encouraged the formation of, similar parliamentary groups to ours and similar forums in Australasia and Africa. All those parliamentarians all over the world are having meetings and making declarations on the very things we have been talking about this afternoon—impressing on their Governments, when they go back home from their meetings, that this is the line that they must take, both in their own country and internationally.

The international parliamentary conference on the implementation of all these declarations, meetings and forums that have taken place among parliamentarians was held in Stockholm earlier this year. Some of us went from our all-party group. This conference agreed that sexual and reproductive health and rights—remember all those elements—should be high on the list for the post-millennium goals agenda. That was only after lobbying the office of the UN Secretary-General after an unsatisfactory interim report was published that did not mention sexual rights or sexual health. It mentioned just reproductive health.

We finally got some movement. We lobbied, and the parliamentarians got together and wrote letters and started making a fuss about this, after all our efforts. I am glad to say that last week we heard from the Secretary-General’s office that the final version of what is called the synthesis report—sorry about the terminology; it is not mine—which was released on Christmas Day, of all days, included the words,

“women’s sexual and reproductive health and reproductive rights”.

That has moved us forward quite a bit: it is mentioned, that is good, they are looking at it. However, the word “rights” still applies only to “reproduction” and not to “sexual”, which means that there is disagreement and concern about a woman’s right to safe abortion, which was mentioned by several speakers. Even after rape, we are still unsure whether women can get a safe abortion. There is no protection against FGM, for example. So we must keep putting on the pressure.

I am sorry, I have nearly finished. I fully understand that these are sensitive issues and I hope that the Minister can tell us that our Government—who have worked so hard on these issues in the last five years and held two special conferences this year alone to deal with FGM and sexual violence in conflict—will insist, at the final conference in September at the UN on the post-MDG agenda, that these issues will be dealt with in full.

Sexual and reproductive health and rights are human rights. We talk about the empowerment of women very glibly, but we cannot ensure that until we allow women to have control over their own bodies. We simply cannot. Women all over the world are depending on us to release them from the position to which they are condemned. We must not let them down.