Such projects have taken steps toward funding some aspects of reproductive healthcare without addressing the full spectrum of needs that are intricately tied to maternal mortality. “This is a preventable problem, not an incurable disease. We know how to save women’s lives,” says Oberdorf. She adds that maternal and family planning, access to safe abortion, and skilled care before, during, and after pregnancy are all specific and realistic solutions that work to save lives; therefore, it is up to governments and funders to increase their will to fund these practical approaches. Acknowledging the larger problem is the first step toward solving it.
Claiming Mothers’ Rights
As Oberdorf notes, this is a preventable problem. “Governments seem to throw up their hands about maternal deaths, as if there is nothing they can do,” says Liesl Gerntholtz, Women’s Rights Director at Human Rights Watch. “But some simple things, starting with tracking deaths and figuring out what caused them, would go a long way toward fixing fatal health system problems.” Accountability begins with monitoring current health data by recording births and investigating maternal deaths. Though this is a first step toward creating positive change, long-term commitment—not only through the provision of medical supplies, but also with larger social endeavors—is needed.
First, simply facilitating access to modern contraceptive methods, many of very low cost, would make a notable difference. A concerted effort must be made to reach women with the greatest unmet need, including rural women, women living in poverty, adolescents, and women in Sub-Saharan Africa, where maternal mortality rates are especially high. Women cite a range of reasons for not using contraception, including infrequent sex, concerns about side effects, breastfeeding, or lack of access to or knowledge about contraception. Opposition by family members, often males, is often a factor in deterring women from obtaining contraception.
In order to address these obstacles, further education is necessary. Schools throughout the world often teach abstinence and condemn any form of contraception, and while perhaps the world would be a simpler place if such teachings worked in practice, governments must accept the reality of human behavior and approach reproductive health pragmatically. The road to long-term progress in reproductive healthcare must begin with changes in social perspective. Relevant education programs must offer comprehensive and age-appropriate sex education for both girls and boys—including, at various stages and ages, discussions of sexuality, explanations of biological changes throughout the life cycle, and instructions on maintaining health and finding services. Such programs also can promote more positive attitudes about gender equality within communities.
“Change begins with altering attitudes on the ground,” says Garita. “We need the types of programs that give girls the self-esteem to have their voices heard and make their own choices in a responsible way.” She adds that existing programs with this goal have been successful in helping young women and girls become aware of their rights and gain the strength to fight for the services they need. “It’s a matter of women being empowered to claim their rights,” she says.
Demographer John Caldwell, too, emphasizes the salience of education. “The extent to which maternal education has been identified as a major—even the major—factor in determining child mortality is astonishing,” he wrote in 1990. In addition to being more knowledgeable about family planning, women with education are more likely to take an active stance in exacting resources for their children and not back down in the face of opposition. The correlation between female literacy and child survival suggests that when women possess more knowledge and agency, their children will not only be taken care of, but will grow up to be similarly empowered.
The enhancement of women’s agency is intertwined with the goals of increased education and literacy, changing social attitudes around gender equality, and rights to bodily autonomy. Providing access to sufficient healthcare and reproductive choices is a critical component of these far-reaching social changes, but until women’s basic rights and gender equality are recognized, reproductive health will remain as underfunded and problematic as it is today. The crisis of maternal mortality constitutes an ongoing barrier to health and development worldwide. As one of the United Nations' key Millennium Development Goals, it is a problem whose solution is within reach, but only if the international community, despite ideological differences, is willing to face up to the crisis as a question of human rights.