Are women worth saving? Of course, the answer is yes. But if we valued our women—mothers, wives, sisters, daughters—why is it that we allow so many of them to die due to easily preventable causes, to causes that already have solutions—cheap and available solutions, at that?

The answer may lie in what Dr. Mahmoud Fathalla, winner of the 2008 UN Population Award, said recently: “Women are not dying of diseases we can treat… They are dying because societies have yet to make the decision that their lives are worth saving.”

If we already know how to prevent women from dying, specifically from dying due to causes related to pregnancy and child birth, then why don’t we do it? Most especially, why aren’t governments moving more aggressively and determinedly to end the scourge of maternal deaths? In the Philippines, 11 women die each day while heavy with child or while delivering their babies.

Our media make much of soldiers dying in encounters with rebels, or of fatalities in road and air accidents or in natural disasters. And yet, this virtual “massacre” of women, one that takes place every day, known to everyone in the community, is routinely ignored and overlooked. It’s as if maternal mortality is a dirty secret—and it is indeed a shameful statistic, when it is high. Experts say that a country’s maternal mortality rate—ours stands at 162 per 100,000 live births—is an indicator of its overall health performance. When a government cannot save the lives and preserve the health of its mothers, chances are it cannot meet the health needs of the rest of its population either.

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QUITE telling at the recent Asia and the Pacific Regional Consultation on Maternal Health and Rights was the list of countries not included among the participants. Sri Lanka was represented only by its health minister, and there was no representative from China, Japan, Korea, Singapore or Malaysia. These are countries which have already achieved an enviable maternal mortality rate, in double- or single-digits, comparable to countries in the developed world.

Sri Lanka was present only to serve as an example of a “low resource” country that was able to bring down the number of maternal deaths by dint of “political will,” devoting resources mainly to the training of midwives, deploying them to villages, and giving them all the necessary support they needed, from medications, supplies and facilities, and even family planning commodities.

For the truth is that, without a rational and efficient family planning program, it will be difficult for any country to significantly reduce its maternal mortality rate. Without the freedom to decide if, when and how often to get pregnant, women are doomed to risking their lives to high-risk pregnancies even when they don’t want to get pregnant, when the time isn’t right, or their health dictates against it. Some 15 percent of maternal deaths worldwide are also due to domestic violence, with women battered and abused even while they are pregnant, the growing belly (and perhaps the woman’s vulnerability) often triggering abusive behavior.

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IN RESPONSE to the problem of maternal mortality, the Department of Health has already issued a policy called “Maternal and Newborn Child Health and Nutrition” (MNCHN), requiring, among other things, that women give birth in facilities where they can be assisted by trained attendants.

The policy also decrees that facilities able to provide emergency obstetric care be set up in every municipality, city or province.

But even with all good intentions, problems continue to hound the DoH in the implementation of the MNCHN. One is that the majority of births in the Philippines still take place in the home, with the woman attended by a hilot or untrained (though not always unskilled) village attendant. The trouble is that when an emergency arises—as when bleeding occurs, or an obstructed labor commences—a hilot may delay transferring the woman to a clinic or hospital, or may have difficulty finding a means of transportation.

Dr. Junice Melgar of the NGO Likhaan said one reason mothers prefer giving birth at home despite the risks is that at home “bida sila” (they are the center of attention). The mother is surrounded by a coterie of care—the hilot or midwife, her own mother and other female relatives—who cater to her every need and hover over her, ready to do her bidding.

“Another problem is that when women do go to a hospital, clinic or health center, they feel ignored or put upon,” said Melgar. They are shouted at, pushed around, even scolded if they have been there too often. And given how public hospitals have become crowded, congested and lacking in personnel, it’s doubtful if mothers would receive quality and compassionate care.

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THAT’S why maternal health is as much a human rights issue as are salvaging and torture. A woman not only has the right to optimal health and health care, she also has the right to a safe and protected pregnancy and delivery.

But she also must enjoy the right to decide for herself if and when she will get pregnant, and the level of care she will receive during pregnancy and delivery, and in the period shortly after.

If women don’t get pregnant, then there is no way for societies to survive. Giving birth to a new generation is women’s way of ensuring the survival of our race, a woman’s way—among many other ways—of contributing to social good.

And yet, as our maternal mortality story continues, it seems that women, instead of being rewarded for their signal contribution, are instead punished and penalized. They “die while giving life.”