Is progress being made on maternal mortality?

Earlier this week, headlines were gleefully reporting the findings from the medical journal the Lancet that touted a big drop in worldwide deaths of mothers during childbirth. Now, those findings are being considered more carefully, since they seem to conflict with a new, separate United Nations report that suggests maternal deaths remain high, possibly as high as 500,000  year. The Lancet's editor even charged that the U.N. pressured the medical journal to delay announcing its findings, and accused the group of playing politics: ""Activists perceive a lower maternal mortality figure as actually diluting their message. Advocacy can sometimes get in the way of science," Richard Horton told the Associated Press.

Here's what the Lancet reported, after assessing maternal mortality levels and trends from 181 countries: "During 1990—2008, rates of yearly decline in the MMR varied between countries, from 8·8% (8·7—14·1) in the Maldives to an increase of 5·5% (5·2—5·6) in Zimbabwe. More than 50% of all maternal deaths were in only six countries in 2008 (India, Nigeria, Pakistan, Afghanistan, Ethiopia, and the Democratic Republic of the Congo). In the absence of HIV, there would have been 281 500 (243 900—327 900) maternal deaths worldwide in 2008."

The report by the Partnership for Maternal, Newborn and Child Health, a global alliance hosted by the World Health Organization paints a much bleaker picture: "Despite significant advances over the past decades, the detailed analysis shows that an estimated 350,00 to 500,000 women still die in childbirth each year; some 3.6 million newborns fail to survive the first month, and an additional 5.2 million children die before the age of five."

It's important to understand where we're actually at on this issue, since maternal health and wellness is a crucial indicator of an overall population's wellbeing, and a reflection of how a given society treats its women. Factors like prenatal care and disease prevention play a large role in preventing complications at birth; and a mother's income and access to education are also shown to impact her and the baby's risk of dying during childbirth.

The Associated Press points out that even if maternal deaths are indeed on the decline, that statistic can mean more than one might think: "In the world of public health, good news can paradoxically be bad news. The more people who are dying, the more money U.N. officials can raise, making some experts less keen to acknowledge that a problem is not as bad as they once thought."

The U.N. report comes as part of an initiative called Countdown to 2015, a global movement created five years ago to measure progress in reducing mother and infant deaths, two of the Millennium Development Goals set by 189 member nations of the United Nations General Assembly in 2000.. "Because we know what causes these deaths and what would prevent them, major progress is possible," says Jennifer Bryce, a child health researcher at Johns Hopkins University and a member of the Countdown group. "The Countdown analysis provides a road map, helping countries focus on their own data and take action to meet their specific needs."

Photo credit: U.S. Navy