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Health facility births key to substantially reducing maternal mortality worldwide

Making sure women throughout the world can give birth in a health facility, in the presence of a midwife, is the best strategy for substantially reducing maternal mortality worldwide, according to a landmark series of papers published by The Lancet today (Thursday September 28, 2006). The authors are calling on governments and donors to prioritise this strategy over alternatives, such as home births with a relative, traditional birth attendant, community health worker or midwife. The five papers that form the Lancet maternal survival series present the evidence for prioritising the health centre strategy and detail the action required for its roll-out, including immediate actions for governments and donors. The authors warn that without political commitment and investment into this approach, substantial declines in maternal mortality are unlikely in the next 10-20 years, and the fifth Millennium Development Goal to reduce maternal mortality by 75% by 2015 will not be met.

Over half a million women die in pregnancy or childbirth each year. The first paper in the Series reveals the stark disparities that exist between rich and poor countries; women in the poorest parts of the world are over 1000 times more likely to die from maternal causes than those in developed countries. For every 30000 women in Sweden, one will die from pregnancy-related complications. In sub-Saharan Africa the average figure is a staggering one in 16 and in South Asia one in 43 the regions with the greatest burden of maternal deaths worldwide. The paper also highlights that most pregnant women die in labour, delivery, or during the 24 hour period after delivery, mainly from severe bleeding and hypertensive disorders. Midwives have the skills to prevent around 88-98% of these deaths but currently, over half the world's women deliver their babies without professional care.

The second paper in the Series assesses the different strategies for reducing maternal mortality. I
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Contact: Joe Santangelo
j.santangelo@elsevier.com
212-633-3810
Lancet
27-Sep-2006


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