Do mothers matter?
Perhaps the most underrated piece of news lately has been the rise in the number of maternal deaths—due to pregnancy- and childbirth-related causes—from an estimated 11 to 12 women dying EVERY DAY.
In a conversation with former Health Secretary Espie Cabral, she told me that according to her own calculations, the maternal mortality rate may even be undercounted. “I believe the number is close to 13 or 14” maternal deaths a day, she said. Whatever—it’s clear that too many Filipino women are dying unnecessary deaths—deaths that could have been prevented if they hand delivered in proper health facilities and were attended by skilled birth attendants, and had access to family planning and reproductive health services when they needed and wanted them.
You think the deaths of mothers while, ironically, giving life, is of no import? Studies show that the total maternal mortality toll (computed before the latest count) as well as that of maternal complications is seven times the number of deaths and disabilities due to TB, 19 times the toll of heart disease, and 20 times that of malaria.
But you wouldn’t think this news counted if you took note of the news agenda around the time the rise in maternal deaths was revealed. At the time, as I pointed out during the policy forum on unintended pregnancies sponsored by the NGO Likhaan, the hottest piece of news was the defeat by Timothy Bradley of our “National Fist” no less, Manny Pacquiao.
Practically every TV set in the country was tuned to the fight, as were TV sets in places where Filipinos gathered. The Independence Day gathering of the Filipino worker community in Taiwan, for instance, was heralded by a free airing of the Pacquiao-Bradley bout, a treat organizers hoped would gather large numbers and lead to heightened spirits of patriotism and pakikisama. Instead, enthusiasm immediately flagged with the decision against Pacquiao, putting an early damper on the event. Continuing heated commentary gives the impression a national disaster occurred!
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Meanwhile, back among the neglected world of women, mothers continue to die in increasing numbers, and it seems as if the news has been met with a shrug and with hands thrown in the air. “Eeeh! Mothers die! What’s new?”
What’s new is that the uptick in maternal deaths here bucks the international trend of falling maternal mortality rates. In the 1970s, before the adoption of a national family planning and reproductive health program overseen by the BkkbN, Indonesia had a maternal mortality rate (MMR) that hovered around 900 per 100,000 live births. Today, that rate has plunged to 190, a considerable achievement, but still disturbingly high.
In the Philippines, our MMR was 162 per 100,000 live births in 2009, but due to various reasons, especially the lack of a reproductive health law, today that rate has increased to 221, higher than Indonesia’s. This makes the achievement of one our MDGs—the lowering of the MMR to 52—increasingly hopeless, unless the government acts swiftly and with political commitment.
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An aspect of the reproductive health environment that has been neglected in most public discussions is inequity: how the “haves” enjoy reproductive health services and absolute freedom to make decisions (and act on those decisions) regarding their reproductive lives; while the “have nots” face restricted choices, mainly due to poverty and lack of access to necessary services.
Also in the same Likhaan forum, former Health Secretary (and now chair of Catholics for Reproductive Health and vice president of the Forum on Family Planning) Alberto “Quasi” Romualdez pointed out how the “upper quintile” (one-fifth) of Filipinos fare in comparison to those caught in the “lower quintile.”
Less than 10 babies born to well-off parents are at risk of dying, while more than 90 babies are at risk among the poorest families, said Doctor “Quasi.” Less than 15 mothers belonging to the richest 10 percent and delivering a baby face the risk of dying during pregnancy and delivery, he added, while more than 130 mothers face the same risk if they are among the poorest.
Economic and social status also affects a woman’s reproductive behavior. While women of status usually are able to exercise their reproductive decisions (how many children, how often), usually resulting in an average of two children, among the bottom 20 percent of the population, women are having twice the number (on average, three or four) of children they wanted or planned for.
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One of the invited reactors, Judy Miranda of the Partido ng Manggagawang Pilipino (Filipino Workers’ Party), disclosed that five years ago, women’s groups were up in arms over reports that locators in special economic zones were requiring women applicants to undergo a pregnancy test before employment. This was based on the reasoning that a pregnant woman might not be able to withstand the rigor of work, and would potentially take time off from work to care for her baby. (Despite laws that mandate support for women’s reproductive health in the workplace.)
But just last year, she added, they received reports that some multinational employers were requiring their women employees or new hires to undergo a virginity test, citing employers in Bataan, Cebu and Region 4. The reasoning was that women risked pregnancy if they were sexually active (well, duh) and would potentially shortchange their employers.
But isn’t reproduction (the pursuit of happiness) a human right guaranteed by the Constitution? And aren’t the government and employers committed to protecting the reproductive rights of women and men?
So is it any wonder no one seems to care if more women are dying from childbirth every day?
