Each year at least 300,000 women - a majority of them in developing countries - die from complications of pregnancy and childbirth, particularly from hemorrhaging after birth. Maternal health advocates gathered in Washington, D.C., this week to share ideas that help save women's lives.
In a perfect world, every baby and new mother would have a safe delivery. The opposite is true, however, for hundreds of thousands of women every year.
That's why the United Nations Secretary-General Ban Ki-moon has declared maternal health and the reduction of maternal mortality by the year 2015 one of the U.N.'s Millennium Development Goals. "A woman dies every minute. This is just [an] unacceptable situation in the 21st century. We must stop the situation."
But women's health advocates at this conference in Washington say a majority of these deaths could be reduced if women got prenatal care and insisted on the help of a skilled birth attendant or midwife.
Deborah Armbruster, a nurse-midwife now with the U.S. Agency for International Development, said, "If we can get women to use skilled attendants who would recognize, you know, that they've got a postpartum hemorrhage, then they can take care of the problems and we won't have women dying, and we won't have such serious morbidities that happen related to that."
Armbruster said women and their birth attendants often prefer to have the baby at home rather than go to a health clinic. And they frequently wait too long before getting help. Once the decision to seek help is made, there are other complications: traveling to the clinic can be dangerous over rough roads, not having the money to pay for medical help, as well as finding the medical facility with a shortage of blood for transfusions.
Like many others in developing countries, women in Bangladesh prefer to have their babies at home. To make that safer, Dr. Shabnam Shahnaz said pregnant women there receive a safe delivery kit, which includes a mat made of absorbent material.
As this training video illustrates, the women lay on the mat as they give birth. If the mat is soaked to the edges, they know to get help immediately because the woman has lost a critical amount of blood.
Dr. Shabnam Shahnaz of Pathfinder International in Bangladesh said, "She would have about two hours to get transferred to a nearby facility." Then she she would go into shock or die.
Other simple means of trapping the blood range from use of a rubberized mat that funnels blood into a container, as well as a neoprene fabric that wraps tightly around the body. The anti-shock garment stabilizes the patient as she waits for help.
There are drugs that help contract the uterus and prevent further bleeding. Dr. Shahnaz said these are in ready supply, but often are held up by local bureaucracy. "The government has these in their supply. It is in their stock. It's easily available in the market."
Shahnaz differs from some health advocates who call for more training of birth attendants and doctors. What's really needed, she said, is for women to be in control of their own care. "To ask the doctors, 'Why aren't you giving it to me? This is needed. I know it is needed. I know these are the steps that need to be taken. Why didn't you do it?' I think this is very, very critical."