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“The very simple answer for teen-aged girls, to help reduce their vulnerability across the board, is to have them at school.”

05/18/2012

EVENT TAKEAWAY

Session - Maternal Health: Milestone Moments on the Path to Healthier Motherhood

Introductory Remarks:  Christy Turlington Burns, Founder of Every Mother Counts; Director/Producer, NO WOMAN, NO CRY

Panelists:

  • Gary Cohen, Executive Vice President, BD (Becton, Dickinson & Company) (Moderator)
  • Sarah Brown, Global Patron of White Ribbon Alliance for Safe Motherhood; President, PiggyBankKids; CEO, Office of Gordon and Sarah Brown
  • Dr. Naveen Rao, Lead, Merck for Mothers, Merck & Co.; Co-Chair, Maternal Health Pillar, MDG Health Alliance
  • Dr. Benjamin Schwartz, Senior Director for Health, CARE USA
  • Rhonda I. Zygocki, Executive Vice President, Policy and Planning, Chevron Corporation

Key points:  

  • There are solutions available to prevent 90 percent of maternal deaths, but the global community has not sufficiently prioritized getting these well-known, effective interventions in place.
  • Education is the number one factor influencing when women get married and start families. Keeping girls in school not only delays first birth among adolescents to a time when their bodies are more ready for motherhood, but also provides access to health education and a safer environment.
  • Targeted programs to decrease HIV infection from mother to child help bring women into the health system and reduce stigmas that may hinder healthier decision-making and outcomes for both men and women.
  • A woman dying in childbirth is largely preventable with known interventions – but the “three delays” affecting births in low-resource settings make these mothers disproportionately vulnerable. More and better post-partum care also is needed to minimize unnecessary maternal deaths. 

Gary Cohen of BD noted that of all the Millennium Development Goals, MDG 5 – reducing maternal mortality – has seen the least progress. Ninety-nine percent of the 350,000 women who die during or after childbirth live in the developing world. Women in industrialized countries have a 1 in 304,000 chance of dying in childbirth. In sub-Saharan Africa, the odds are 1 in 31. Maternal mortality is the leading cause of death among women aged 15 to 19 in low-resource settings. And girls under the age of 15 are five times more likely to die while giving birth than women in their 20s.

Sarah Brown, Global Patron of White Ribbon Alliance for Safe Motherhood, said an important focus related to maternal deaths should be on keeping girls in school, which provides not just academic training but also health education, access to nutrition, and a safer environment that reduces exposure to the threats of sexual violence and child marriage. “The very simple answer for teen-aged girls, to help reduce their vulnerability across the board, is to have them at school.” 

One of the major opportunities for corporations to improve maternal health outcomes is to address risk factors for women through existing workplace health programs. Rhonda Zygocki of Chevron shared that the company’s HIV/AIDS programs included efforts to understand and reduce culturally-induced stigmas, so as to encourage HIV testing and other behavioral changes for employees and their spouses and families. 

In particular, Chevron Corporation decided it needed to do something to prevent the transmission of HIV infection from mothers to newborns. It started a program in and around several of its operations in Africa. The number of infections in newborns at its Nigeria location in the past 11 years ago and in Angola in the past seven years has been zero.

After Zygocki shared these results, a ripple of conversation passed through the audience. Gary Cohen broke in. “That has to bring a lot of confidence that we can reach zero transmissions,” he said, referring to the global goal of preventing all pediatric HIV infections by 2015.

Naveen Rao, Lead for Merck for Mothers, Merck & Co.’s new signature initiative to reduce maternal deaths worldwide, said women in developing countries often face three delays before delivery that exacerbate the risk of mortality: seeking care, getting to care, and receiving care. He said all three delays could be mitigated with proven, low-cost solutions.

Benjamin Schwartz of CARE USA said much more could be done to make sure women receive care after delivery, including the first hours post-partum. In the Bihar state of India, near the Nepal border, he said a recent check of 90 women found that none of them had an exam at the health facility before being sent home just a few hours after giving birth. He said that the WHO recommends three post-partum visits after delivery, “preferably in their home; most have to take place at home,” he said. “In Bihar, we found only 12 percent of women received those visits. Most of the mortality to mothers occurs then.” He also emphasized the importance of skilled community health workers, the need for better access to family planning and the impact of socio-cultural norms on health outcomes.

Christy Turlington Burns, the model, filmmaker, activist and founder of Every Mother Counts, told the audience during her introductory remarks that she became a maternal health advocate after she had a difficult birth. Although safely handled by her doctor, her complication could have been deadly for a woman in the developing world. “I felt compelled to use my voice and to do all I can to prevent these senseless deaths,” she said. She made a film called No Women, No Cry, documenting stories of mothers around the world. “We know what many of the solutions are,” she said. “We just need to take these solutions to scale more often to reach more women.”

Naveen Rao took the challenge one step further.  “We know what is killing them,” he said. “We know why they die, and we stand around watching them. … It’s a question of saying enough is enough. We need to decide whether mothers are worth saving.”

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