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Maternal mortality: a problem whose time has come

, : Maternal mortality: a problem whose time has come. International Health News 9(7): 4-4

This article discusses the prevention of maternal deaths in developing countries through the use of contraception. High risk women (those younger than 18, those 35 or older, or those with 4 or more children) have usually been the focus of such efforts. The author argues however that family planning programs which are not focused on any particular age or parity group may actually be more effective. Most women probably use contraceptives to limit family size or for spacing purposes, not to avoid dying in childbirth. In the World Fertility Survey, about 4 in 10 married, fecund women said they wanted no more children, yet 7 in 10 were not using an effective method of contraception. If all these women were able to avoid unwanted pregnancies, an estimated 3 out of 10 maternal deaths could be averted. Other reasons concentrating on certain age or parity groups may be inappropriate include: 1) high risk women have lower birth rates; therefore the majority of maternal deaths may actually occur among "low risk" women, 2) many women wish to stop having children before they reach age 35 or have 4 children, 3) illicit abortions are a major cause of death in developing countries; therefore any unwanted pregnancy is high risk, 4) some women genuinely want more children although they have 4 or more, or are 35 or older, and, 5) confining attention to the usual high risk groups encourages an inappropriately clinical view of contraceptives. The main conclusion is that making family planning services available and accessible to all women is one of the ways which must be used to prevent maternal deaths in the Third World.


PMID: 12179877

Other references

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