Maternal Death Rates Remain Alarmingly High
Research conducted by the World Health Organization, the United Nations and the World Bank released today concluded that maternal death rates are declining too slowly to meet international goals set in 2000.
The new maternal death statistics show there has been virtually no progress in reducing deaths for the past 15 years in countries where mortality rates are already the highest; sub-Saharan African nations, for instance, account for more than half the world's maternal deaths.
The international agencies say universal access to reproductive health services must be prioritized to reverse the trend.
The report follows the release of studies that found that abortion rates dropped sharply between 1995 and 2003, particularly in places where abortion is legal.
Released to news outlets on Thursday, the joint research from the World Health Organization and the New York-based Guttmacher Institute found abortions worldwide had declined to 29 per 1,000 women of childbearing age in 2003 from 35 abortions per 1,000 in 1995. The lowest rates were recorded in Western Europe, where abortion is largely legal and women have better access to contraception.
The lack of safe abortion services in many developing countries continues to take a toll, killing about 67,000 women annually and hospitalizing 5 million others, according to the report, published in the Oct. 13 edition of British medical journal The Lancet.
In an accompanying analysis, Guttmacher concluded that safe access to abortion and increased family planning and reproductive health services could curb the toll and substantially reduce maternal mortality. The research organization estimates that more than 100 million women worldwide have unmet needs for contraception.
Timed Delivery of Data Load
The twin load of global data on women's health came in a week when the U.S. House of Representatives Foreign Affairs Committee had been scheduled to hold hearings on a U.S. policy barring aid to foreign clinics that provide abortion-related services or advocate for change in local abortion laws.
The federal policy is coming under growing political criticism following its repudiation by both houses of Congress over the summer.
Officially called the Mexico City Policy because it was first announced by President Reagan at the International Conference on Population in Mexico City in 1984, detractors call it the global gag rule because it bars funded groups from not only providing abortions but also from counseling women on abortion and lobbying on the issue.
Due to the death from breast cancer of a committee member, Rep. Jo Ann Davis of Virginia, the hearings are being rescheduled and are likely to be held in late October.
Critics say the policy has hurt family planning access in Africa.
"The global gag rule has totally dismantled the tradition of family planning services in Kenya," said Joachim Osur, one of the experts invited to Congress to testify at the hearings and to brief committee staff members yesterday.
Osur oversaw medical services for Family Health Options Kenya when the affiliate of the International Planned Parenthood Federation stopped receiving U.S. funds after refusing to agree to the gag rule.
Shuttered Clinics and Programs
He told Women's eNews that the loss of funding forced him to close clinics that provided 100,000 women annually with gynecological and family planning services and screenings for breast cancer, cervical cancer and HIV-AIDS.
He also shuttered the organization's training program for counselors who provided family planning services; education and mobilization efforts to encourage public use of family planning services; and a network of 1,000 health workers distributing contraceptives to 200,000 women annually.
Wendy Turnbull, senior policy research analyst at Population Action International, a Washington-based international family planning group, says U.S. funding for family planning assistance is down 41 percent since its high-water mark in 1995.
"A lot of nongovernmental organizations doing reproductive health are, if anything, just holding the line."
Under the rule, foreign nongovernmental organizations must sign pledges that they will not provide abortions, counsel or refer women on the procedure, or lobby to make abortion legal or more available, even if the costs of those services are funded from separate sources.
The Senate voted to overturn the policy in its entirety in September, while the House passed provisions that restore U.S. Agency for International Development (USAID) shipments of contraceptives to foreign organizations that refuse the terms of the policy.
Turnbull said there is not yet enough political support for a full repeal of the policy in the House and President Bush has promised to veto even the contraceptives exemption, which enjoys broad bipartisan support.
Ellen Starbird, assistant director of USAID's Office of Population and Reproductive Health, said the agency had successfully allocated all of its funding to organizations that agreed to comply with the policy "with an emphasis on the countries where the need is greatest." USAID is the largest international family planning donor in the world, she said.
Policy Start in Reagan Administration
President Reagan first instituted the rule to attack abortion with a policy that was easier to implement than a domestic ban. He announced it during the lead-up to his 1984 re-election and it has been in effect under every Republican president since.
President Clinton repealed the policy, but President George W. Bush reinstated it as his first official act in office on Jan. 22, 2001, the 28th anniversary of the Supreme Court's Roe v. Wade decision that affirmed the legality of abortion in the United States.
The policy has broad opposition from Democratic presidential candidates.
Sens. Hillary Rodham Clinton, Christopher Dodd and Barack Obama co-sponsored the amendment in the Senate to repeal the policy, a vote which Sen. Joseph Biden skipped. In the House, Rep. Dennis Kucinich voted for the amendment that repealed the ban on donated contraceptives. Former Sen. John Edwards and Gov. Bill Richardson of New Mexico oppose the policy on their campaign Web sites.
While opponents say it is impossible to calculate the number of women affected by the policy, the Global Gag Rule Impact Project, an online database, documents the effects of the policy in Ethiopia, Ghana, the Dominican Republic, Nepal, Romania, Tanzania, Kenya, Zambia and Zimbabwe.
The project finds that the loss of funding for family planning is reducing the capacities of organizations to carry out other key services for women, such as screenings for cervical and breast cancer, and pre- and post-natal care.
Population Action International's Turnbull says the reduced capacities of these groups is likely to hinder initiatives such as introducing new vaccines which fight the humanpapilloma virus to prevent cervical cancer.
Eighty-five percent of deaths from cervical cancer occur among women in developing nations, according to the National Cervical Cancer Coalition, an advocacy group based in West Hills, Calif.
The project also finds that the policy is undermining the fight against HIV-AIDS at a time when 75 percent of young people infected with HIV in sub-Saharan Africa are female, according to Avert, an international AIDS charity based in the United Kingdom.