The Safe Motherhood Initiative and beyond

In 2007 the Safe Motherhood Initiative is celebrating its 20th anniversary. Many countries have been able to improve the health and well-being of mothers and newborns over the last 20 years. However countries with the highest burdens of mortality and illness have made the least progress and inequalities between countries are increasing. In many places inequalities within countries are increasing too between those who live in better conditions and have access to care and those who for a variety of reasons are excluded. Globally the numbers remain staggering: each year there are at least 3.2 million stillborn babies 4 million neonatal deaths and more than half a million maternal deaths. The majority of these deaths are avoidable. HIV/ AIDS and malaria in pregnancy are having an impact on maternal mortality and could reverse the progress that has been made. A total of 11-17% of maternal deaths occur during childbirth itself; 50-71% occur in the post-partum period. The time spent in labour andgiving birth the critical moments when a joyful event can suddenly turn into an unforeseen crisis needs more attention as does the often-neglected post-partum period. These periods account not only for the high burden of post-partum maternal deaths but also for the associated large number of stillbirths and early newborn deaths. (excerpt)