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African Maternal Mortality Defies Global Trend

African experts on maternal mortality are meeting in Addis Ababa this week amid encouraging news of a worldwide decrease in the number of women dying from pregnancy and childbirth.  But Africa still lags behind other parts of the world in making childbirth safe.

The overall picture is hopeful.  A study published this month in the Lancet medical journal shows a significant drop worldwide in the number of mothers dying during pregnancy or childbirth.

But while the overall news may be positive, conditions in Africa remain at emergency levels.

The Lancet study says in 2008, six countries accounted for nearly half of all maternal mortality cases.  Three of them, Ethiopia, Nigeria and the Democratic Republic of Congo, are in Africa.

Opening a continental meeting of experts, Ethiopia Minister of State for Health, Kebede Worku, pointed to alarming numbers.

"One-million maternal / newborn deaths occur annually with African women having a one-in-16 chance of dying from complications of pregnancy," Worku said.  "Africa contributes about 47 percent of global maternal mortality.  Sub-Saharan African countries have the highest rates; 34 percent of all maternal deaths in Africa are due to unsafe abortions," said Worku.

The authors of the Lancet study say it is based on more sophisticated statistical methods than previous reports, and includes three times more data.  But many attending the Addis Ababa conference say they believe the Lancet study paints too rosy a picture of Africa.

U.N. Population Fund representative Etta Tadesse is among the skeptics.  She says existing programs are good as far as they go, but are too small to meet the challenge.

"It is not a total failure.  Things are working, but it is not at par with the challenges.  Women still die every day, as you and I speak now, so we still have a long way to go," she said.

Despite the grim outlook, a few family planning experts see bright spots on the horizon.  Grethe Peterson, of Marie Stopes International, points to Ethiopia as an example of a country where relaxing abortion laws has reduced the maternal mortality rate.

"In May, 2005, the government Ethiopia liberalized the abortion law, which under some circumstances made it possible to get access to safe abortions.  Every year until then, one-third of all maternal deaths were because of unsafe abortions.  That meant more than 7,000 women died every year from an unsafe abortion," said Paterson.

Petersen says the number of deaths has been coming down, despite the difficulty of getting the word out to Ethiopia's rural population about the change in the law.

Experts attending the continental meeting say much more work is needed to determine whether the tide is indeed turning in the fight against maternal mortality.  But the Lancet study is seen as a first sign of hope against a problem that in Africa has long been seen as intractable.

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