Population Matters

Maternal Mortality: Great News, But More to Do

May 21st, 2012

A new report, Trends in Maternal Mortality: 1990 to 2010, released last week by the World Health Organization (WHO), United Nations Children’s Fund (UNICEF), United Nations Population Fund (UNFPA) and the World Bank brings us great news for mothers around the world. Since 1990, the number of mothers who die every year from pregnancy-related causes has fallen from more than 543,000 to 287,000 – a 47 percent drop. This is great news for mothers around the world, but it is not enough.

Progress has not been equal and there are countries, particularly in sub-Saharan Africa, that will not meet Millennium Development Goal Five to reduce maternal mortality by 75 percent by 2015. In sub-Saharan Africa, a woman faces a 1 in 39 lifetime risk of dying due to pregnancy or childbirth-related complications. In South-eastern Asia, the risk is 1 in 290, and in developed countries, it is 1 in 3,800.

Even with this reduction, there is still one woman dying every two minutes and 800 women dying every day. The real tragedy is that while 99 percent of these deaths take place in the developing world, most of them are easily preventable. We know what needs to be done in order to prevent maternal deaths. Women need access to family planning services and supplies, they need access to midwives or health workers trained with midwife skills, and they need access to emergency obstetrical care if they have complications.

In stressing the importance of family planning, Dr. Babatunde Osotimehin, Executive Director of UNFPA said:

“Over a quarter of a million women still die in pregnancy and childbirth each year, and more than 215 million women lack access to modern contraceptives. Meeting the need for voluntary family planning for these women would not only fulfill a human right, it would also reduce the number of maternal deaths by a third. This is a highly cost-effective public health strategy.”

This is particularly significant as the House Appropriations Committee marked-up the State and Foreign Operations Budget for FY2013 (fiscal year 2013) last Thursday. As the bill currently stands, it would cut international family planning funding to $461 million.  That’s $149 million below the current funding level and $180 million below the President’s request for FY2013. The bill also cuts off all funding for the United Nations Population Fund (UNFPA).

These cutbacks would have a profound impact on women’s lives around the world. According to the Guttmacher Institute, a $149 million cut in international family planning assistance would mean:

  • 8 million fewer women in poor countries would receive contraceptives;
  • 2.2 million more unintended pregnancies;
  • 1 million more unplanned births;
  • More than 1 million more abortions (745,000 of which would be unsafe);
  • 6,000 more women would die from pregnancy-related causes.

These cuts in the U.S. budget will be a setback to this progress. We cannot continue to make progress for the 287,000 women who are still dying every year if donors are cutting back on their support. It is imperative that we continue to support family planning and maternal health programs so that we can continue to see great news like this 47 percent reduction in maternal deaths.

Tell your elected representatives in Congress that it is time to halt the assault on contraceptives and reproductive rights.

Posted by Jennie Wetter, Director of Public Policy

Congress: A House Divided

May 16th, 2012

When it comes to issues relating to women, family planning and reproductive health, Congress is a House divided.  Within the next few weeks, the Senate and the U.S. House of Representatives will be taking action on international family planning assistance.  For those who are concerned about women and their families in the developing world, the stakes could not be higher.

The House Appropriations Committee this week is expected to take up the State Department and Foreign Operations Appropriations bill, which contains funding for international family planning assistance.  As the bill currently stands it would cut international family planning funding to $461 million. That’s $149 million below the current funding level and $180 million below the President’s request for FY2013. The bill would also cut off all funding for the United Nations Population Fund (UNFPA).

These cutbacks would have a profound impact on women’s lives around the world. According to the Guttmacher Institute a $149 million cut in international family planning assistance would mean:

  • 8 million fewer women in poor countries would receive contraceptives;
  • There would be 2.2 million more unintended pregnancies;
  • There would be 1 million more unplanned births;
  • There would be more than 1 million more abortions (745,000 of which would be unsafe); and
  • 6,000 more women would die from pregnancy related causes.

And in case you think that this is about saving taxpayer’s money, think again.  Family planning, whether here or abroad, substantially reduces expenditures on other health care costs and, dollar for dollar, is perhaps the most effective means of improving the well-being of women and their families.

While the U.S. House of Representatives is expected to approve a large cut in international family planning assistance, the hope is that the U.S. Senate will strongly support the President’s budget request.  But this showdown is far from over.

With the House leadership threatening to fight another battle over the debt ceiling unless more deficit reduction measures are adopted, the level of Congressional funding for international family planning for 2013 and beyond is far from assured.

Now, more than ever, the American people need to let their elected Representatives know how strongly they feel about family planning, both at home and abroad.

Isn’t it time to halt the assault on contraception and reproductive health?

Posted by Jennie Wetter, Director of Public Policy

The Perfect Gift for Mom

May 12th, 2012

This Sunday is Mother’s Day and I’ve been thinking a lot about what I should get my mom to celebrate. My mom and I are really close and I wanted to make sure that what I got her had meaning so she would know how important she is in my life. What do you get the person who was always there for you, the person who stood by you even when you knew you had disappointed them? Who was by your side cheering when you overcame obstacles? What can you get her to say thank you for raising you to be the person you are today?

I began thinking about all the things I could get her and how she doesn’t really need them. The more I thought about it, the more I thought about the issues I work on here, like sexual and reproductive health, family planning, and maternal health. And how on Mother’s Day 1,000 women – or one woman every 90 seconds – will die due to pregnancy-related causes. Most of these deaths are easily preventable and 99% of them are in the developing world. That adds up to over 350,000 women dying every year while trying to give life.

The good news is that we know what needs to be done to drastically reduce the number of women dying from pregnancy-related causes; invest in family planning and maternal health care. On the maternal health side there are five major cause of maternal mortality: hemorrhage (severe blood loss), sepsis (infection), unsafe abortion, hypertensive disorders (pregnancy complications associated with high blood pressure, including preeclampsia and eclampsia), and obstructed labor. They are all treatable if the woman has access to trained healthcare workers and a well-equipped health facility.

Family planning, in particular, will help to lower the maternal mortality rate by reducing pregnancy-related deaths.  By investing in family planning internationally, we can prevent unintended pregnancies and abortions, and save the lives of mothers and their children. Right now there are 215 million women of reproductive age who would like to time or space their births differently or stop having children all together, but they are not using modern contraceptives and are said to have an unmet need for family planning. By meeting the existing unmet need, maternal deaths would be reduced by around 35 percent.  Investing in international family planning saves lives.

After thinking about all of this my decision was easy. My mom doesn’t need more things, but what the world needs is more moms to live to be there for their children like my mom was there for me. That is why instead of flowers this year I made a donation in my mom’s name buying a safe birthing kit for women giving birth in places where hospitals have been destroyed and doctors are in short supply. Hopefully the Mother’s Day gift I bought for my mom will ensure one mother will live to be there for her child they way that my mom was there for me. For me I couldn’t think of a more perfect gift for my mom than to make sure the world has more moms like her.

Happy Mother’s Day!

Posted by Jennie Wetter, Director of Public Policy

A Victory for Youth at the CPD

May 8th, 2012

I recently attended my first Commission on Population and Development (CPD) at the United Nations in New York City, not knowing what to expect. After hearing about the way events unfolded just a month and a half earlier at the Commission on the Status of Women (CSW), where for the first time in CSW history no “Agreed Conclusions” document was produced, I was feeling nervous. The issues of most contention were related to women’s access to comprehensive sexual and reproductive health care, including family planning, control over their sexuality and protection of their reproductive rights, comprehensive sexuality education, and eliminating harmful practices such as early and forced marriage (including child marriage). With the theme for this year’s CPD being “Adolescents and Youth” I was worried that the CPD would be just as contentious as the CSW.

When I got to the UN I was excited to see not only all of the youth in attendance, but the number of youth who were part of official delegations. It was great to look around the room and see so many youth engaged in the CPD process to ensure their rights would be protected.  Beyond all of the youth were the “retired youth” (my favorite new term from the CPD), including myself, who were determined that the CPD would not be a repeat of the CSW.

After a week of intense lobbying and negotiations the delegates agreed to a strong resolution in support of young people’s sexual and reproductive health and human rights.  The key points from the final resolution include:

  • The right of young people to decide on all matters related to their sexuality;
  • Access to sexual and reproductive health services, including safe abortion where legal, that respect confidentiality and do not discriminate;
  • The right of youth to comprehensive sexuality education;
  • Protection and promotion of young people’s right to control their sexuality free from violence, discrimination and coercion.

While the document wasn’t perfect (it didn’t, for example, include sexual rights as opposed to reproductive rights, there was no mention of sexual orientation or gender identity, and it didn’t include global access to safe abortion) it was clearly a victory for youth and adolescents around the world.

In the next couple of years there is the twenty year review of global sustainable development goals (Rio +20),  the twenty-year  review of progress towards achieving the Cairo Programme of Action (ICPD+20), and the review of the Millennium Development Goals. All of these processes will likely have a major impact on sexual and reproductive health and rights.

Let’s take this strong statement on young people’s sexual and reproductive health and human rights and use it as a stepping stone in these upcoming processes.

Posted by Jennie Wetter, Director of Public Policy

A Triumph for Youth and Adolescents

May 3rd, 2012

Last week the UN hosted the 45th Session of the Commission on Population and Development (CPD).  This year’s session, which focused on youth and adolescents, produced a powerful outcomes document that breaks new ground on a host of issues relating to the reproductive health and rights of young people, including the importance of comprehensive sexual education in ensuring that young people are able to make informed choices about their own reproductive health.

I have asked our Public Policy Director, Jennie Wetter, who joined me last week in New York, to report on the historic nature of this year’s session, but in the meantime, I wanted to share with our readers the reflections of Suzanne Ehlers, the President and CEO of Population Action International.  Suzanne has written a terrific blog , “Everything I Needed to Know about the UN I Learned in Kindergarten,” that looks back at the people and processes that led to the final declaration.  It’s a wonderful piece.  I hope you will read her entire blog, but let me share with you a few of her key observations:

The effort last week on behalf of young people around the world resulted in a resolution that speaks plainly but powerfully about adolescents and youth. It speaks to their need for sexual and reproductive health, reproductive rights, safe abortion, and the end to harmful practices like FGM and early and forced marriage. As we move into global reviews of various development-related agreements (from Rio to the ICPD to the MDGs), this CPD resolution gives us wind in our sails for the inevitable hard work ahead.

It reminds us that issues related to young people can be controversial and divisive. It reminds us that international development matters.

And it reminds us that those inspiring little quotes that people put at the bottom of their emails—from Gandhi, Margaret Mead, and the like—are grounded in a deep and sacred truth and deserve to be read daily, in a quiet moment:

Believe in a better world, and then work for it.

Well said.

Posted by Robert J. Walker, President