Keeping Maternal Mortality on the Agenda at UN Human Rights Meeting

Linda Coale died of a blood clot a week after giving birth to her son, Ben, by c-section. The infant welcome packet included extensive information about acclimatizing pets to a new baby, but had failed to adequately alert her to warning signs of complications, despite the heightened risk due to her surgery.

On Friday, the United States will appear before the UN Human Rights Council (HRC) for its “Universal Periodic Review” (UPR).  The UPR is a process through which the human rights records of all 192 UN Member States are reviewed once every four years.

I have come to Geneva to monitor the US’s participation in the UPR and to educate both the US government and those of other member states, on Amnesty International’s concerns about the state of human rights in the United States. In April, Amnesty submitted a written report to the HRC detailing our US human rights concerns, ranging from the use of the death penalty, to the need to establish a commission of inquiry into all war on terror-related detention policies and practices, the need to bar racial profiling in law enforcement, and the need for a human rights executive order to help establish a domestic human rights infrastructure.

Today I had the opportunity to speak about another tragic human rights issue that Amnesty has been focusing on: maternal mortality in the United States.  At the event, hosted by the Center for Reproductive Rights, I featured the findings of our report, Deadly Delivery: The maternal health care crisis in the USA and discussed the maternal health crisis in the United States, particularly among marginalized communities.


Maternal Death Clock Ticks in Times Square

Yesterday morning, as world leaders began a summit at the United Nations to review progress on the Millennium Development Goals, Amnesty International activists converged on Times Square to launch a “maternal death clock”, keeping track of the number of women who are dying in childbirth worldwide. Decisions made at the summit will have life-or-death consequences.

Every 90 seconds, somewhere in the world, a woman dies in childbirth. That’s 40 women every hour — almost a thousand mothers lost every day. The vast majority of those deaths are preventable. 99% happen in developing countries.

The annual rate of decline is less than half of where it needs to be to meet the MDG target of cutting maternal deaths by 75% by 2015. The fight against maternal mortality — and the fight against poverty — won’t be won until the international community puts human rights at the heart of the struggle.

You can join the Amnesty members who took that message to the streets of Times Square this morning — sign Amnesty’s petition and tell world leaders that poverty is a human rights crisis!

African Activists' Struggle to Improve Maternal Health

Activist Juliette Compaoré says the MDG summit will have an impact in Burkina Faso © Amnesty International

New UN statistics released last week show that world leaders are struggling to keep their promise of cutting the maternal mortality ratio by 75 per cent by 2015. For activists in Sierra Leone, the slow progress is no surprise.

Many people don’t understand that maternal health is a human rights issue and so many other factors contribute to these deaths. Discrimination, lack of facilities, domestic violence and poverty… if these underlying issues aren’t addressed, it will undermine the good work that is being done,” says Victor L Koroma, an activist based in the capital Freetown.

Koroma’s small organization, the Campaign for the Promotion of Health and Human Rights Activities, campaigned to abolish medical fees in Sierra Leone. In April, the government took the landmark step of introducing free healthcare for pregnant and breastfeeding women.

However, Koroma warned world leaders gathering this week in New York to discuss progress on the Millennium Development Goals (MDGs) that more still needs to be done.

“We need to go beyond free healthcare because there are lots of problems. Many midwives are not properly trained and drugs and blood are not available. Nutrition is completely ignored. Drugs are unevenly distributed and there is discrimination – whether on the basis of tribe, gender, social status or political affiliation.

“World leaders, donors, the UN and the World Bank all need to do their bit if a country like Sierra Leone is to be saved from the ravages of pregnant women dying every day.”

Koroma paints a harrowing picture of the scale of the maternal health crisis facing MDG decision-makers.

“Sexual and gender-based violence is rampant; women and girls as young as five are being raped. Many then become infected with HIV. Yet the government does nothing. In the last year only two people have been sentenced for violence against women out of probably thousands of cases,” he says.

The UN statistics show an average annual decline of 2.3 per cent since 1990, falling way short of the 5.5 per cent decline needed to reach the 2015 target. Although a woman is no longer dying every minute, the new statistics show that one woman is still dying every minute and a half.

Severe discrimination and the low social status of women also fuel the high rate of maternal deaths in Sierra Leone, where women’s health needs are given low priority by their own families and community leaders.

Most maternal deaths in Sierra Leone take place in rural areas cut adrift from hospitals. Most women die in their homes. Some die on the way to hospital; in taxis, on motorbikes or on foot.

MOMS for the 21st Century

Amnesty International’s pathbreaking report, Deadly Delivery, documented the maternal health care crisis in the United States: women in the United States have a greater lifetime risk of dying of pregnancy-related causes than women in 40 other countries, with African-American women dying at an almost four times greater rate than Caucasian women.

As Amnesty’s Mother’s Day briefing on Capitol Hill showed, legislators recognize the urgency of this issue and are responding.

Today, one of those champions is stepping up and introducing a vital new piece of legislation. Rep. Lucille Roybal-Allard’s (D-CA) “MOMS for the 21st Century Act” would:

  • Strengthen a geographically and racially diverse maternal health care workforce
  • Improve research and data collection on maternal health care, including identifying health professional shortage areas and promoting evidence based maternal care
  • Elevate and coordinate work on maternal health care within the Department of Health and Human Services

Amnesty International is proud to enthusiastically support the bill. The MOMS for the 21st Century Act is the first in a series of legislative initiatives that we’re working on — stay tuned for more news in the weeks to come!

Posted in USA

Free Our Midwives!

Older daughter Mirabelle holding Jadzia just minutes after a home birth.

Normally I write on this blog about human rights issues in South Asia.  But, I’m also the proud father of two gorgeous (in my opinion!) daughters who were born with the loving help of a midwife.  My youngest daughter, Jadzia, was born in late September 2009 at our home, delivered by a wonderful home birth midwife, Kate Finn.

However, unless New York passes the Midwifery Modernization Act, other expectant mothers might not be able to receive quality care from midwives in New York State as my wife and daughters received, likely resulting in increased barriers to maternal care, something documented extensively by Amnesty International.  You can take action to help pass this legislation in New York!


Posted in USA

Speaking Out for Maternal Health in Washington DC

On May 6, the Thursday before Mother’s Day, Amnesty International, Childbirth Connection, the NAACP and the White Ribbon Alliance, in cooperation with Chairman John Conyers (D-MI) and Reps. Gwen Moore (D-WI) and Lois Capps (D-CA), organized a congressional briefing on the maternal health crisis in the United States and around the world. In this post, four DC-area Amnesty members and activists reflect on the event.

Foreground, L-R: Chairman John Conyers (D-MI) and Amnesty International USA Executive Director Larry Cox.

Foreground, L-R: Chairman John Conyers (D-MI) and Amnesty International USA Executive Director Larry Cox.

Becky Farrar:

Last week’s congressional briefing on maternal health was a fantastic event – with fabulous speakers and a standing-room-only crowd. And after this week’s introduction of the Global MOMS Act, last week’s panel feels like a wonderful prelude.

The introduction of the Global MOMS Act is very exciting news for all U.S. Amnesty members who have been actively campaigning on maternal health, and calling for action. Last week’s briefing was just one of the many actions Amnesty International has taken to bring attention to the maternal health crisis. Members have made worry dolls, taken online actions and made calls to their Congressional representatives and the Department of Health and Human Services, and visited Congressional offices and actively lobbied for an Office of Maternal Health.


Speaking Out for Maternal Health in Detroit

On April 17, Detroit hosted the second stop of the maternal health speakers tour. In this post, Reuben Metreger, a law student at Wayne State University and Amnesty International state legislative coordinator for Michigan, looks back on the event.

As I reflect on the Deadly Delivery Detroit event I am reminded of what long time Detroit co-group 78 leader and new area coordinator Ken Grunow said. In Detroit we will all need to become midwives and mid-husbands to deliver the rebirth of our city. Amnesty International leaders from around the world gave us a good first push. As we begin to demand dignity and take on poverty it seems clear that a common problem is inequality for women and minority groups and that it is people power, not technology that will make it happen.

As if on cue the technology failed us. The sound system went out, but our leaders did not skip a beat. They were able to communicate the old fashioned way, from the heart.

Larry Cox, executive director of AIUSA, told us that although we are the richest country in the world, we still rank behind forty other countries in terms of lifetime risk of dying in pregnancy or childbirth.

Silvia Rosario Loli Espinoza, executive director of AI Peru, told us through her interpreter that although her country is considered a middle income country, they are the third worst in Latin America when it comes to maternal mortality. Unfortunately, there is still a lack of resources and women are not even provided with basic needs like food and transportation. Other problems have to do with discrimination against indigenous people and women in the country which contribute to poor outcomes. She described a technique called vertical delivery where women give birth while standing; indigenous women often prefer vertical delivery, but too many Peruvian health professionals are unable to facilitate the technique, or even actively discourage it.

Yves Boukari Traore, executive director of AI Burkina Faso, told us that his country is one of the economically poorest in the world. Poverty is a leading cause of maternal mortality, yet the problem is more than a lack of resources — it is a lack of will. We watched an inspiring video of women on the Amnesty International caravan delivering the message that maternal mortality is a serious problem and that when the community joins together to demand dignity, the government will have to respond.

The most hopeful news of the day came from Brima Abdulai Sheriff, executive director of AI Sierra Leone. Although he told us that Sierra Leone facing many of the same challenges as Burkina Faso, his government has announced that health care will be provided free to pregnant women in his country!

It was inspiring to get to see first-hand Amnesty activists from around the world and to recognize that our problems have much in common. We all need to come together to join Amnesty International and demand dignity for all people! As Ken said, we all need to help support pregnant women to ensure that birth is a joyous occasion that we can all celebrate.

Speaking Out for Maternal Health in San Francisco

This post is by Cecilia Lipp, AIUSA San Francisco Organizing City Activist Leader.

L-R: Larry Cox of Amnesty International USA, Maddy Oden of the Tatia Oden French Memorial Foundation, and Yves Boukari Traore of Amnesty International Burkina Faso

L-R: Larry Cox of Amnesty International USA, Maddy Oden of the Tatia Oden French Memorial Foundation, and Yves Boukari Traore of Amnesty International Burkina Faso

San Francisco hosted AIUSA’s maternal health speakers tour at the San Francisco Public Library Wednesday night. Amnesty International executive directors from Sierra Leone, Burkina Faso, Peru and the United States presented the findings of AI’s reports on maternal health in their respective countries, and outlined their campaigns to make every birth safe.

The panel discussion, moderated by Diana Campoamor, president of Hispanics in Philanthropy, took us through from the international to the local level. The statistics at every level are shocking. But what stays with me most are the stories of individual women denied access to lifesaving health care.

L-R: Yves Boukari Traore of Amnesty International Burkina Faso, Brima Abdulai Sheriff of Amnesty International Sierra Leone, Sameer Dossani of Amnesty International USA, and Silvia Loli Espinoza of Amnesty International Peru

L-R: Yves Boukari Traore of Amnesty International Burkina Faso, Brima Abdulai Sheriff of Amnesty International Sierra Leone, Sameer Dossani of Amnesty International USA, and Silvia Loli Espinoza of Amnesty International Peru

Maddy Oden, founder of the Tatia Oden French Memorial Foundation, shared the intimate story of the loss of her daughter, Tatia, after an induced labor at a respected San Francisco Bay Area hospital. Tatia’s daughter Zorah passed away as well. Before speaking, Maddy lit a candle to honor the spirits of the women who have died while giving life.

In a room filled with midwives, local elected officials, our local human rights organizations and people who are all parents and children, it was so important for us to be brought back to the fact that the issue of maternal mortality is not just a question of abstract statistics or lofty human rights ideals. This is a concrete, flesh-and-blood issue that affects every person in the room, and the inspiration for this work lies in the fact that this is a crisis we can fight! These deaths, like Tatia’s, are unnecessary and preventable, especially in the United States, where geography and infrastructure do not pose a problem in the way that it might in rural Burkina Faso.

L: Silvia Loli Espinoza of Amnesty International Peru

L: Silvia Loli Espinoza of Amnesty International Peru

We looked at solutions in our community, such as the bill for single-payer health care in California championed by Senator Mark Leno, supported by partner organizations including OneCare California. We, as a community, can also look to support education solutions that the Tatia Oden French Foundation proposes including increasing women’s awareness of their rights within the health care system, including the right to refusal. It’s imperative for our community to ensure that all women get everything they need to be fully informed participants in their care.

This event was a call to action: to come together in solidarity with one another and protect the life of every woman in our global community who chooses to give birth. Let us make sure every woman knows her rights, let us hold the medical community accountable (not culpable, but responsible), let us support the practice of midwives and doulas to support women in birth, let us ensure that women are visited by doctors and community members before, during and after their birth.

L-R: Maddy Oden of the Tatia Oden French Memorial Foundation (hidden), Yves Boukari Traore of Amnesty International Burkina Faso, Brima Abdulai Sheriff of Amnesty International Sierra Leone

L-R: Maddy Oden of the Tatia Oden French Memorial Foundation (hidden), Yves Boukari Traore of Amnesty International Burkina Faso, Brima Abdulai Sheriff of Amnesty International Sierra Leone

We have our work cut out for us, but I became convinced this week that we can make this change in our community here in San Francisco. Could you do the same thing in your community? Will you work for a crucial national solution — an Office of Maternal Health? I will remember the life of Tatia Oden French and the other women just like her who die every day within the United States alone. Let us stand together in solidarity and transform this unnecessary and heartbreaking reality.

Maternal health is a human right. Motherhood and birth deserve dignity, so let us demand dignity for ourselves, our sisters, our daughters, our partners.

Despite Progress Maternal Mortality Remains a Crisis

By Rachel Ward, Managing Director, Research Unit

News coverage of the study published in The Lancet about declining maternal deaths worldwide largely ignored the appalling fact that the United States has shown no improvement in the rate of maternal deaths for two decades.

Progress in reducing maternal deaths around the world should be applauded.

Yet even if we accept the study’s conclusion that there has been some progress on reversing maternal deaths worldwide, this should not lead us to the wrong conclusion — that the problem is solved.

Far from it.

Women are still dying worldwide at an appalling rate — a woman dies every minute and a half worldwide, according to the figures published in The Lancet.

Most of these deaths, we know, can be prevented.  This study should strengthen our resolve to develop strategies to expand upon the progress so that  the right to safe childbirth is protected for all women everywhere.

In the United States, the Lancet study shows that maternal deaths are on the rise.  The recent Amnesty International study we co-authored, Deadly Delivery: The Maternal Health Care Crisis in the USA, shows that the maternal death rate has shown no improvement in the United States in more than two decades, and in fact, the death rate is going up.  This is a disgrace.  And the rate is climbing, despite the fact that hospitalization related to pregnancy and childbirth costs some $86 billion a year — the highest hospitalization costs of any area of medicine.


Posted in USA

Mapping the U.S. Maternal Health Care Crisis

AGM Countdown: In the run up to Amnesty International’s Annual General Meeting in New Orleans this weekend, the Science for Human Rights program will be posting new blog entries throughout the week. All of the projects presented this week—and many more—will be on display in New Orleans.

On March 12, 2010, we released Deadly Delivery: The Maternal Health Crisis in the USA, our groundbreaking report on maternal health in the United States. Deadly Delivery lays out a clear case for the ways in which the U.S. health system is broken, and how we can fix it to fulfill the right of all women to maternal health.

Map of US maternal mortality ratios, based on information in Deadly Delivery: The Maternal Health Crisis in the USA. © Amnesty International. Produced by AAAS. <strong>CLICK TO SEE FULL MAP.</strong>

Map of US maternal mortality ratios, based on information in Deadly Delivery: The Maternal Health Crisis in the USA. (c) Amnesty International. Produced by AAAS. Click to see full map.


One of the most shocking facts, illustrated in this map, is that the numbers vary immensely from state to state. A woman in Washington, DC, is almost 30 times more likely to die from complications of pregnancy or childbirth than a woman in Maine. Maine is one of only five states (the others being Indiana, Massachusetts, Minnesota, and Vermont) that have met the Healthy People 2010 goal of 4.3 maternal deaths per 100,000 live births. Most states’ ratios are far above that, and maternal health statistics in the USA have not improved in 20 years.

Inequalities abound. Amnesty International researchers found that women in the United States faced barriers to quality health care that included discrimination, language barriers, cost, bureaucratic hurdles, shortages of health care providers, and a lack of standardized national protocols to prevent and respond to life-threatening complications. Women of color are disproportionately affected, as are rural women, women in the inner cities, and women who do not speak English. African American women are nearly four times more likely to die of pregnancy- or childbirth-related complications than white women.

With a map like the one above, some of these disparities become immediately apparent. With such blatant inequalities from state to state, the United States needs better coordination and accountability on maternal health at the national level.

That’s why Amnesty International is calling on Kathleen Sebelius, Secretary of Health and Human Services, and President Obama to create an Office of Maternal Health in the Department of Health and Human Services. The office would ensure comprehensive data collection and effective nationwide review; ensure access to timely prenatal care; issue evidence-based protocols to prevent, recognize and respond to the leading pregnancy complications; encourage home visits after childbirth; vigorously enforce federal nondiscrimination laws; and recommend regulatory and legislative changes to ensure quality maternal care for all women.

Take action now by writing to Secretary Sebelius!