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Evelyn Leopold

Evelyn Leopold

Posted: September 20, 2010 03:07 AM

UNITED NATIONS - The statistics for maternal mortality have improved by 34 percent. That means a woman is no longer dying every minute, but one woman is still dying every minute and a half.

No doubt prenatal care, malnutrition, access to a hospital and skilled practitioners and professionals could prevent most of the deaths. As could education for girls that keeps them in school longer.

But the squeamishness of talking about family planning or contraception -- in short sex -- is a no-no in many nations. An estimated 215 million women in the developing world want to delay or avoid pregnancy but have no access to contraception or fear the side effects or their families object, says the UN Population Fund (UNFPA).

With President Obama participating, the United Nations is holding a summit this week on its Millennium Development Goals (MDGs), the world's most ambitious program to slash poverty by 2015. While the glass is half empty on many of the goals, the decline in deaths of pregnant women is nowhere near the target of a 75-percent reduction by 2015.

Consequently, UN Secretary General Ban Ki-moon scheduled a side-event on the deaths of pregnant women and children under five years of age on Wednesday, the last day of the three-day MDG summit.

It's not that UN agencies don't talk about contraception and the draft outcome document, for the summit mentions family planning, sexual and reproductive health several times, including "ensuring that women, men and young people have information about and access to the widest possible range of safe, effective and acceptable methods of family planning." But the wish list is not duplicated on the ground. (My fantasy was to offer a "morning-after pill" to the 150 women recently gang-raped in the Congo.)

Child brides
Marriage of child brides, whether forced or by consent, can be a recipe for disaster in bearing healthy children. Says the International Women's Health Coalition, an expert in the field:

Child marriage is the major cause worldwide of pregnancies before age 15. In most of the developing world, 90 percent of girls who give birth before age 18 are married. Young brides typically become sexually active as soon as they are married, sometimes before their first menstruation. Often living in their husband's household and community, they face intense pressures to bear children as soon as possible, with potentially disastrous results."

As many as 50 percent of pregnancies in developing nations are unplanned and 25 percent are unwanted. The unwanted pregnancies are disproportionately among young, unmarried girls who lack access to contraception. In Ethiopia, for example, about one third of all maternal deaths each year could be averted if women had access to reliable family planning methods, UNFPA says.

Thoraya Obaid, the executive director of UNFPA, proposes "a one-stop-shop, where they can get family planning; care before, during and after childbirth; nutrition advice and services for HIV and AIDS," adding: "If every woman enjoyed the right to sexual and reproductive health, maternal death and disability would be rare and not the devastatingly common tragedy it is today."

Mother-in-law decides
Access to birth control is one problem. But even in some nations where the government has reproductive health clinics, the "mother-in-law often makes the decision," Nafis Sadik, the former director of UNFPA, once said.

In Pakistan, for example, a government survey found that 84 percent of the women who want to limit family size do not use modern family planning methods. And among those that do, sterilization is most popular. Illegal abortions are also common with close to a million carried out each year, according to the Population Council of Pakistan.

Patricia Licuanan, a Filipino psychologist and educator, and the current chairman of the Commission on Higher Education, has said that despite the Obama administration's support of reproductive health, "religious fundamentalism is on the upsurge."

She was not wrong about the Philippines, which together with Malawi, last week sponsored a panel of gifted health specialists from around the world, who opposed contraception as well as abortion. Several argued that legal abortions were not necessarily safe and that maternal deaths would not be reduced through contraception, only by proper health care, and that condoms did not necessarily reduce AIDS. (Both the Philippines and Malawi have extraordinarily high rates of maternal mortality.)

There is another side of religious leaders as evidenced by Rev. Debra Haffner who helped organize an open letter among religious leaders on the UN conference, saying in part: "We are called to bear witness to the harsh reality that without comprehensive sexual and reproductive health services, women and girls around the world suffer illness, violence and death."

Clearly contraception is not a panacea for sepsis, severe bleeding, obstructed labor or even the consequences of illegal abortion. Health care in many countries is too tenuous that even sophisticated women worry about surviving a difficult birth. Dr. Asha-Rose Migiro, the UN deputy secretary-general, told a luncheon at the UN Foundation of her fears at the birth of her second child in her native Tanzania where she was a professor and then foreign minister. The doctors, she said, were excellent but the equipment so outmoded "I was afraid for my life" when she needed a cesarean section.

There is no easy answer and nothing works without community involvement, the reduction of extreme poverty, health practitioners at the village level, cell phones for emergencies -- and a proper analysis of available data, much of it sketchy. UNICEF, the UN Children's Fund, found that statistics masked differences within a country between those in relatively prosperous areas and the rural or slum-dwelling poor in developing countries.

And one could add -- in the United States also.

 

Follow Evelyn Leopold on Twitter: www.twitter.com/evjournalist

 
 
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HUFFPOST SUPER USER
Just4theHalibut
11:15 AM on 09/22/2010
"My fantasy was to offer a "morning-after pill" to the 150 women recently gang-raped in the Congo."
My fantasy was to offer a female condom to all Congolese women, that has a lubricant that causes the rapists' tools to shrivel. Permanently.
12:53 PM on 09/21/2010
iam from uganda which is a developing country ive worked in its rural settings and still do and ive seen that poverty and poor access to health facilities leads to most obstetric complications and increased levels of maternal mortality ,besides that, the health facilities might be accessible in some cases but very poorly equipped in terms of qualified medical personnel,drugs and equipment and usually referral services are so poor that in case of an emergency the mother cant be transported or will be delayed and may die eventually..On the social aspect rural women are governed by their husbands who have a negative attitude towards family planning and will not allow their wives to access any family planning methods.
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HUFFPOST BLOGGER
Evelyn Leopold
Veteran UN correspondent
09:14 AM on 09/21/2010
Thanks so much for your interesting comments. The key, however, is choice, not forced population control. For one, the more education a girl has, the later she will wait to have a child. And information and access to birth control is slim, either for political, religious or financial reasons. Money also is scarce. UNFPA got a boost in US funds but the effort is still paltry compared to the need. The same for the many ngos in the field. Keep the thoughts coming. EL
03:51 PM on 09/21/2010
Thank you, Evelyn, for your report. It is heart-breaking to see that we still have so far to go when it comes to Human Rights, the disparities between rich and poor and fundamentalism vs. free thinking.

Comes The Light. 1 min. animated poem of Hope. http://www.youtube.com/watch?v=_F2e84alIFg
07:18 AM on 09/21/2010
Evelyn Leopold is right; world leaders at the UN summit should definitely be talking about sex.
If they truly want to tackle world poverty, then getting family planning services to women in poor countries should be top of their agenda.
Having worked on health programmes in Africa, Asia and Latin America, I’ve seen the desperate need for modern family planning methods, for midwives and basic reproductive health care. More than 215 million women worldwide lack access to these services. The UN summit must address this as an absolute priority today.
In 2009, Marie Stopes International’s annual impact report found that our family planning services had averted 35,600 maternal deaths (http://www.mariestopes.org/documents/publications/Global-impact-report-2009.pdf). We’ve been doing this work for 30 years and we know the difference it makes to the lives of women and their families. We also know it is a prerequisite for tackling poverty.
We’re calling on people everywhere to watch our films from across the world and pledge their support for the Make Women Matter campaign (www.makewomenmatter.org).
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HUFFPOST SUPER USER
lingal17
12:16 AM on 09/21/2010
Brutally honest and definitely on point! Please keep the conversation going. Maybe someone will finally listen!
11:08 PM on 09/20/2010
We must find our equilibrium with nature, otherwise we will die just like parasites in a dead host's body. It is that ugly of a situation. It's good to know that people are thinking about ways to reverse the trend.
08:07 PM on 09/20/2010
To help humans infinitly better is called as a group a type of Chiropractic that can help but only as good as the spinal disks will allow. When symptoms occur a human is unaware of a lot of internal damage that has already occurred. beginnings of worsening damage can begin with the trauma of birth incident being shaken as a baby or any traumatic accident. Therefore time is important for this physical body that dies shining no light like Gods body does..Skilled upper cervical specific practitioners on www.upcspine.com,No drugs are necessary to clog a body that does not need them.
First off I want to say we are animals that think to much,and as result will hurt each bother like Jesus would not want us to do. Now I will tell you a lovingly kind way to solve your sticky problem elegantly. the answer is zoosexuality, zoophile net. do this, and contraception of all kinds will not have to be used. Have U,C,S, care as learned about on up www.upcspine.com, and ailments of all kinds of descriptions will not have to be worried about. Maintain visits according to the individual,and best to make an appointment as soon in life as possible from the time you are born on up. Some will have a spine in to bad a shape to be helped so don't delay, and be one of them.Must avoid diversified ask whoever if they are or not,and.no full spine chiropractors too.
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HUFFPOST SUPER USER
sylvialafair
06:42 PM on 09/20/2010
This article is a wake up call for me. In the '70's I was the Philadelphia chair of what was then Zero Population Growth, now called Population Connection. I just rejoined, feeling really embarassed by my laziness until I read Evelyn Leopold's eloquent words.
As a business leadership expert and relationship coach I teach that two of the most powerful areas that impact lives center around birth and death. I hear so many stories of the "secret" tensions concerning conception, contraception, religious belifs, feeling unwanted, being a burden, that leave lasting imprints of shame, anger, and betrayal.
We have the knowledge and resources to ensure that every woman around the world who wants to limit her childbearing can do so.
What the world needs now are empowered adults who can raise off-spring in open hearted, caring ways. The emotional health of new generations, the health of the planet, depends on more discussions about population control, sexuality, intimacy, and male female partnership.
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HUFFPOST SUPER USER
daniejoe
06:22 PM on 09/20/2010
so we have overrpopulation in an increasingly overpopulated world of exponentially decreasing resources. like fishing and animal habitat and food grown with lots of chemicals to increase production. We have the responsible control of this problem in the hands of those who JUST dont GET that our world can not handle this. We can do culling of horses and wolves and all other species but we wont police ourselves. I do not agree that there is no easy answer. There is. Man's arrogance. Religious fundamentalism regardless of religion has one tenet universally. Man wants to control the reproductive rights of women. Simplistically as it sounds, a woman's place is barefoot and pregnant and apparently quiet. I do not indict Islam for this. The Christian churches, specifically, the Church of Rome, takes equal footing on this issue. How many times a popular pope has told a country overpopulated with burgeoning poverty and health issues, birth control is a sin. Man's arrogance: child brides. Be real. It is the man who wants to or thinks he has a divine right to make sure he is the first man in her life and the only man. This is it, folks. Are women complicit? yes, it is called socialisation. So many turmoils and problems are rooted in this arrogance even when it is cloaked in a divine cassock or burqah. That is truly the tragedy. If the dinosaurs are one up on us: they didnt bring themselves down. We will do that too.
04:26 PM on 09/20/2010
We are hell-bent on overpopulating ourselves into extinction. No biologic system can stand the type of environmental pressures we are placing on the world's natural resources. The human population explosion has brought us to the brink of a natural calamity which will lead to our extinction.
Mankind is following in the footprints of the dinosaurs.
05:02 PM on 09/20/2010
Wrong. Dinosaurs had no knowledge. Humans will "survive." It may not be pretty though.
03:59 PM on 09/20/2010
By the time your children, reach middle age, the population of this planet will double. Instead of worrying about global warming, or health care, or fossil fuel depletion, or even the economy. This, more than anything else, is our most immediate concern. How many news stories have you read, about this looming threat and its implications? What will the consequenses be when we reach a world population 14 Billion? How many people know that Nigeria's population will surpass the United States in the next 30 to 40 years?

This scares me and I think it should scare you. Unlike the possibilities of scientific achievement, simple goodwill and fate to mitigate the effects of all other concerns, the growing population is inevitable.

I think our leaders fail us, once again. They tell us we're poisoning our air and water, we're cutting down our forests, we're depleting our resources and people are starving and dying in child birth.. What will our children face when they reach middleage.

The UN meets several times a year. They fight over trade routes. They squabble over Climate Change money, poverty and the economy. Nobody seems to notice, or wants to talk about the driving force behind all these dilemmas. Nobody sees the 800 pound gorilla in the room.

Wake up people. If we ignore this and only concentrate on the symptoms, your children's future may be in peril.
HUFFPOST SUPER USER
rmhopper3
03:30 PM on 09/20/2010
condoms and sensible laws that were enforced would change all this
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groland
socially left, fiscally right
02:18 PM on 09/20/2010
We cannot change third world attitudes that are based on centuries of tradition and honor. Ironically, one reason families push for more children is precisely because of the high rates of infant mortality. It takes generations for attitudes to change and adapt. By reducing childbirth and infant mortality, even under the best of circumstances, we are unlikely to change sexual practices for many generations. I don't put much hope in changing third world practices, when we cannot even promote sex education and contraception without objection from evangelical Christians here in our own country.
04:29 PM on 09/20/2010
China, at the time a 3rd world country, imposed a freeze on family size. This led to economic stability, higher levels of education and a nation rivaling ours on the world stage.
All it takes is leadership.
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05:57 AM on 09/22/2010
An advantage to a more totalitarian government, and a disadvantage of democracy.
12:48 AM on 09/21/2010
Financial security and a comfortable lifestyle coupled with effective, simple and safe birth control brings birthrates down. European and North American women who already had the first dropped their birthrate as soon as they had female contraception. And all those millions of Catholic women found that the sky didn't fall if they took the pill. Now in India the new middle class who are achieving the first condition are choosing to have two children. Feeling secure in your own retirement prospects, feeling confident that these few children will survive and not needing labour for shop or farm for the family to survive makes it easy to say two is enough. However if those other conditions are not met people will not take those kind of chances. Birth control is not enough.
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Just Catie
intelligent, articulate and a left-leaning veteran
01:48 PM on 09/20/2010
Unfortunately for all women, almost all religious organizations preach that a woman may not use birth control. Because men don't like condoms, and the religious organizations consider them to be a form of birth control, awareness of both birth control and condoms in thirld world countries is very low. Most religious organizations preach that each child is a gift from "god" (insert appropriate diety here) and using birth control is a "sin" (insert punishment/wrong doing here). Women in third world countries can be viewed as objects for sexual pleasure and breeders, once they become pregnant. The idea that abstinence works is laughable, but once the woman (or girl) is married, she has no right to say no to the demands of her husband. We should work on empowering women to take control of their own reproductive systems.
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01:44 PM on 09/20/2010
The UN does not have the authority or power to make or enforce these changes in its members countries, religion or culture. We are a long way from a united federation of planets, UN, united states county, city or the rules of your particular social club being accepted and enforced by all simply because we can not agree on practically anything we need to like saving the planets destruction from the actions of humans. Oil addiction remains strong, our ocean is becoming a plastic soup, Forests animals and fish are disappearing, we have to purchase water to drink or filter it, our air and food is full of poison and religion is actually accepted, tolerated and used while it is the cause of things in this article. and nothing is done to solve the real problem because no matter how cruel, mean or whatever the consequences, no matter how illogical no matter what evidence is presented . . .religion it is given a free pass to persecute kill and torture again and again. And the big issue on the table at the UN is to protect religion. Is there any accountability anywhere, maybe in the after life, ya right !