Saving Mothers

Over the weekend, I read an article in the Huffington Post by Christy Turlington discussing maternal health legislation in the US. Most people probably know Christy Turlington as a supermodel, but she’s also the founder of the organization Every Mother Counts and directed/produced a documentary on maternal mortality entitled “No Woman, No Cry.” Ms. Turlington is currently touring the US screening her film and her article in the Huffington Post deals with the issue of maternal mortality in the US, specifically with the introduction of H.R. 894.

Earlier this month, U.S. Representative John Conyers, Jr. (D-Michigan) introduced H.R. 894, the Maternal Health Accountability Act of 2011. The bill would provide grants to states intented to improve maternal health and data collection on mortality rates. As a condition of receiving grants, States would be required to:

• Require health professionals and facilities to report pregnancy-related deaths
• Investigate and develop case findings and summaries for each occurence
• Establish review committees with ob-gyns, nurses, social workers, health care facility representatives and other relevant stakeholders to recommend prevention strategies
• Disseminate findings and recommendations

Additionally, the Department of Health and Human Services (HHS) would be required to:

• Research disparities in maternal care, risks, and outcomes, and improve the capacity of the performance measures to measure disparities
• Expand access to services that have been demonstrated to improve the quality and outcomes of maternal care for vulnerable populations
• Compare the effectiveness of various interventions to reduce maternal health disparities

It’s important legislation, but it remains to be seen whether the House has an appetite for taking on this kind of project in the current political environment. The issue of maternal mortality in the U.S. is below the radar for most Americans, which adds to the challenge of pushing a bill like this through. So it’s nice to see someone as visible as Christy Turlington championing the cause. Looking forward to seeing her full film when it’s released later this spring.

Have you heard of Lynsey Addario?

I hadn’t, until just this past week. Lynsey Addario was one of the four American journalists working for the New York Times who was kidnapped and held hostage in Libya for six days by forces loyal to Colonel Qaddafi. It’s a pretty harrowing story, and it’s pretty incredible that all four journalists finally made it home to safety (you can read their account here). Anyway, today a friend sent me an article in Jezebel talking about Lynsey, who was the only woman journalist to be captured, and it piqued my interest. It turns out she’s a pretty amazing woman. With no previous experience, Lynsey began taking photographs professionally in the mid ’90s, focused on humanitarian issues. Since then, she has made a name for herself as a photojournalist, covering conflicts in Darfur, Congo, Afghanistan, and Iraq, as well as shooting features in many other countries. She has won a Pulitzer prize and a MacArthur fellowship.

It’s kind of shocking how accomplished this woman is.

Anyway, she has a wonderful website that gives an idea for the flavor of her work. In particular, I was drawn to her series of photos of Mama Seesay, a young woman from Sierra Leone who died from a post-partum hemorrhage. The series is entitled “Maternal Mortality in Sierra Leone: One Woman’s tale of Dying to Give Birth.” The pictures are beautifully taken and deeply sad. Sierra Leone has an average of 900 maternal deaths per 100,00 live births (compare to roughly 11 per 100,000 in the US) and seeing photographs like this really brings this message home.

It’s wonderful that someone as gifted as Lynsey is bringing attention to the issue. So check out the pictures. Tell us what you think. 

Last week, in the wake of the 100th anniversary of International Women’s Day, I read an article by Nicholas Kristof in his column for the NY Times “On the Ground” and thought it might be appropriate to discuss that article here. The article was entitled “Do Women Leaders Matter?” and it attempts to address the uncomfortable truth that women in power often do a poor job of promoting women’s rights or key women’s issues within their own countries.

Kristof answers his own question here, but it’s a complicated answer. “Women leaders do matter. But it’s less obvious to me that women leaders at the top of a country, at least initially, go out of their way to improve things for women citizens at the bottom.” Kristof’s view seems to be that, generally speaking, women leaders in high-level government positions have had relatively little positive impact on women’s issues such as maternal health or education.

But why?

Kristof offers a few answers. To begin, he uses the example of the female Bangladeshi Prime Minister Sheikh Hasina as the sort female leader who has not served the best interests of her female population by doggedly persecuting Muhammad Yunus, the Nobel Peace Prize winning founder of the Grameen Bank, who’s global contributions have aided impoverished women worldwide. While Kristof hastens to add that Prime Minister Hasina should not be considered representative of all female political leaders, he uses her story to show that being female isn’t enough to ensure that a leader will do right by the female population in her country. As Kristof says, “it’s a reminder that the struggle to achieve gender equality is not a battle between the sexes, but something far more subtle. It’s often about misogyny and paternalism, but those are values that are absorbed and transmitted almost as much by women as by men.”

It is this complicated struggle that makes Kristof’s question here so interesting. How much responsibility does a female leader have to advance women’s issues just because she’s a woman? Should it be different for a female leader than a male leader? Why or why not?

Kristof points out that it is often women leaders at the grassroots level who are most influential, as they seem to be the ones to push for important local women’s initiatives. But he doesn’t really address why women at this level seem to do a better job than their more high-ranking female counter-parts. He suggests that is possibly an issue of critical-mass: even if there is a female prime minister, she may be one of very, very few females in the government and therefore less likely to prioritize female issues. But that’s not a very satisfying answer, at least to this reader.

Thoughts?

The other day I read an article that got me thinking. The article, by Cleo Fatoorehchi. was entitled “Pregnancies Don’t Wait for Emergencies to End,” the gist of it being that when societies are ravaged by disasters- earthquakes, tsunamis, floods- pregnant women often pay a very high price. Of course this makes sense. The humanitarian response usually focuses on immediate necessities like providing emergency medical care, food, and temporary shelter- and of course these are all essential essential services. But there has been a lack of support services for women in the wake of disasters. Armed conflict or natural disaster leaves a vulnerable population of women even more exposed to harm.

The U.N. Population Fund and Women’s Refugee Commission (WRC) have developed an updated version of the Inter-Agency Field Manual on Reproductive Health in Humanitarian Settings to help address the gap in care for pregnant women in times of crisis. The manual is designed for doctors and midwives, as well as for policymakers and donors and offers guidance for both immediate and long term reproductive health service. So not only is there information on how to care for pregnant women in resource-limited settings, there is information about family planning services and how women can protect themselves from contracting sexually transmitted diseases.

Providing sustainable care for women- pregnant or otherwise- in the aftermath of a crisis is clearly a challenging goal, and one that won’t be solved by a manual. But the updated manual signals awareness of the issue that is an important step in the right direction.

Photo credit: Life Magazine