At the 51st Directing Council of the Pan American Health Organization/World Health Organization (PAHO/WHO), in Washington, D.C., health leaders from across the western hemisphere supported a plan that aims to accelerate reductions in maternal mortality, increase awareness of maternal morbidity and mortality, and prevent serious maternal morbidity in the Americas.

According to PAHO, approximately 9,500 women die in the Caribbean and Latin America annually due to pregnancy-related causes. PAHO/WHO professionals say that as many as 95% of the deaths in these areas can be prevented by using knowledge that is already available.

PAHO Director Dr. Mirta Roses, explains:

“This makes maternal deaths unacceptable in the Region of the Americas. Governments should mobilize the necessary efforts to prevent these deaths.”

The following are the most prevalent causes of pregnancy-related deaths:

  • hypertension (high blood pressure) – 26%
  • complications resulting from unsafe terminations – 13%
  • hemorrhage – 21%
  • sepsis – 8%
  • obstructed labor – 12%
  • other causes – 15%

Pregnancy-related deaths have declined between 29% and 41% (depending on data sources) in the western hemisphere since 1990. Meaning that the progress for the region is not on track to achieve the Millennium Development Goal (MDG) target of a reduction of 75% in pregnancy-related deaths by the year 2015.

Several of these deaths are the outcome of unwanted pregnancies as well as limited access to contraceptives. Many countries have laws that restrict access to contraceptives and because of this women frequently resort to unsafe terminations as a method of contraception. In the Caribbean and Latin America the rate of unsafe abortion is 31 per 1,000 women aged between 15 to 44, in comparison to the rest of the world at 22 per 1,000 women.

Other factors that contribute to pregnancy-related deaths include inequities in prenatal care and during childbirth: 74% of pregnant women in urban areas have four prenatal visits in comparison to just 46% of those living in rural areas. Afican descendants, poor, and indigenous populations receive less healthcare coverage, poor health care quality and higher pregnancy-related death ratios.

The plan requests that proven interventions should be put into action to reduce pregnancy-related deaths, especially free access to care for preconception, prenatal, labour, and postpartum by qualified professionals. As well as collaborating with ministries of health, the plan also requests that partnerships be strengthened including the Regional Working Group for the Reduction of Maternal Mortality (GTR) and similar partnerships with scientific associations, civil society organizations, and academic groups

Specific measures suggested in the five-year plan of action include:

  • Increasing the coverage of contraceptives as well as increasing the availability of family planning counseling before conception and after an obstetric event.
  • Giving individuals access to affordable, high-quality care during all stages (preconception, prenatal, labor, and post-partum), by level of maternal and perinatal care.
  • Starting measures aimed to prevent and detect family violence during pregnancy.
  • Increase numbers of qualified health professionals in basic and emergency obstetric units.
  • Making more staff available 24-hours to attend births and deal with obstetric complications.
  • Introducing as well as consolidating perinatal and maternal information and monitoring systems
  • Creating groups to evaluate and address pregnancy-related death, with participation from the community.

Dr. Gina Tambini, PAHO Area Manager for Family and Community Health, explains:

“We know there’s been progress, but we also know from statistics we have at the regional level that we still have a lot of work to do. That’s why we have worked for the last six months to identify where there are gaps and to mobilize the necessary efforts and resources.”

Written by Grace Rattue