Safe Motherhood and Reproductive Health

The right to safe motherhood: Taking stock and looking forward

This edition of MTb takes us back to 1987, the year in which the Working Party on International Safe Motherhood and Reproductive Health (WP) was established under its former name Dutch Consultancy for Maternal and Child Health. The focus has always been on women’s health in low income countries and non-western immigrants in the Netherlands. Thirty years have passed, and while the number of maternal deaths worldwide has decreased, it is still unacceptably high at around 300,000 per year. Members of the WP are active in both individual and collective projects directed at improving maternal and reproductive health. While the original focus was on obstetrics, nowadays urogynaecology and gynaecologic oncology are addressed as well. During the era of the Millennium Project (2000 – 2015), the work of the WP was targeted to goal 4 and 5, reducing child mortality and improving maternal health. Unfortunately the targets have not been met; the unfinished agenda has been reformulated under the 2030 Agenda for Sustainable Development. Each day 830 women die during pregnancy or within 42 days of termination of pregnancy from causes related to the pregnancy or its management, with 99% of these cases taking place in lowincome countries. Around 80% of these deaths are caused by obstetric complications like excessive blood loss, sepsis, hypertension, obstructed labour and complications related to unsafe abortion. The startling fact is that Most of these deaths could have been prevented, if women had received quality care in time. Due to limited access to care because of unavailability of services, long distances to be covered, transportation problems, too few skilled health workers, cultural beliefs or genderbased inequality, women often do not get the right care at the right time. Good medical care for women throughout their lives is a basic human right and vital to the prosperity of every country. This requires well-functioning health systems, as well as efforts to influence determinants of health. Acknowledging the importance of properly functioning health systems and the comprehensiveness of such activities is key to improving safe motherhood and reproductive health. This edition is dedicated to safe motherhood and reproductive health and contains contributions from several WP members, including the PhD researches on health workforce issues in Ethiopia and Afghanistan and the description of the collaboration of several partners with the Gondar University in Ethiopia. The articles on obstetric fistula and cervical cancer draw attention to gynaecologic problems which pose a particular high burden on women in Low Income Countries, and which – in the case of cervical cancer – is often diagnosed at a late stage. Maternal care includes care for all women throughout their lifespan; the case-report shows that rare but severe gynaecologic conditions can even occur in a teenage girl. The book The war on women and the braves ones who fight back is an overwhelming account of violations against women, showing a grim picture of women’s lives. At the same time however it urges to ‘fight back’. Marleen Temmerman dedicated her lifelong work to improving women’s and reproductive health worldwide. In this interview, she passionately shares her ideas on acting locally whilst thinking globally. She is an inspiration for us all. Let this MTb stimulate you to continue doing whatever you can to help women in need.

Myrrith Hulsbergen
Jelle Stekelenburg