Deaths caused by reproductive health inequality

According to a UNFPA report, poorer or marginalized mothers such as African women are 130 times more likely to die from complications in pregnancy or childbirth than those in Europe and North America.
Una mujer con su bebé escucha al personal del UNFPA en una sesión de sensibilización sobre violencia de género en el One Stop Centre del hospital de Sominé Dolo - © UNFPA Mali/Amadou Maiga
A woman with her baby listens to UNFPA staff at a sensitization session on gender-based violence at the One Stop Centre at Sominé Dolo Hospital - © UNFPA Mali/Amadou Maiga
  1. Stalled progress
  2. Pockets of inequality
  3. Reproductive rights belong to all

While there has been progress in sexual and reproductive health, which became a global priority three decades ago, the world has made no progress in saving women from preventable deaths in pregnancy and childbirth. 

In a new report released Wednesday, the United Nations Population Fund (UNFPA), the UN's sexual and reproductive health agency, reveals a serious inequality between countries, with more than half of maternal deaths, 62%, occurring in countries in a state of crisis or conflict. 

Similarly, Intertwined Lives, Threads of Hope highlights the role that racism, sexism and other forms of discrimination play in blocking progress in sexual and reproductive health. 

Women and girls trapped in poverty are more likely to die prematurely from inadequate health care if they belong to minority groups or are trapped in a conflict environment, according to the report. 

"On sexual and reproductive health issues, the sad reality is that instead of working together, there is a kind of polarised dialogue, a divisive attitude and, in a way, a 'second-class citizen' attitude when it comes to the rights of women and girls," Natalia Kanem, UNFPA's executive director, told UN News in an interview. 

In the space of a generation, we have reduced the rate of unwanted pregnancies by nearly one-fifth, cut the maternal mortality rate by one-third, and achieved laws against domestic violence in more than 160 countries," Kanem said. 

Stalled progress

Such progress is stalling in several key areas. In a world where a quarter of women cannot say no to sex with their partner and nearly one in 10 have no say in contraception, 800 women die every day in childbirth, a worrying figure unchanged since 2016. Almost 500 of these preventable deaths per day occur in countries experiencing humanitarian crises and conflict. 

"The world made zero progress in saving women from preventable deaths in pregnancy and childbirth," Kanem said, adding that, for the first time, data was collected on whether women's bodily autonomy is strengthening over time. 

In 40% of the countries where data are available, autonomy is weakening due to an inability to reach "those furthest behind," she added. 

There is a clear disparity between the global North and South, West and East, when it comes to contraceptives, safe delivery services, respectful maternity care and other essential services, the report documents. 

Pockets of inequality

Even within these regions, however, "pockets of inequality" exist, the report stresses. Women of African descent in the Americas face higher maternal mortality rates than white women, which is especially evident in the United States, where it is three times the national average. 

Indigenous and ethnic minorities also face high risks related to pregnancy and childbirth. 

In Europe, in Albania, for example, more than 90% of Roma women from the most marginalised socio-economic groups had problems accessing healthcare, compared to only 5% of Albanian women from the most privileged strata. 

In addition, women with disabilities are up to ten times more likely to experience gender-based violence, and people of diverse sexual orientation and gender expression face significant violence and barriers to care. 

Reproductive rights belong to all

The report stresses the importance of tailoring programmes to the needs of communities and empowering women and girls to develop and implement innovative solutions.

It estimates that investing an additional $79 billion in low- and middle-income countries by 2030 could prevent 400 million unintended pregnancies, save 1 million lives and generate $660 billion in economic benefits.

"Women are half of society and women are stepping forward to claim their full rights. We believe that the ability of human society to thrive really depends on who is vulnerable," Kanem told UN News.

The ability to secure reproductive health rights, in the executive director's view, is another major challenge.

"It is indeed the responsibility of men to defend women's reproductive rights, the reproductive rights of all," Kanem said.