|All Authors / Contributors:
A Rosenfield; D Maine
The authors are responding to a LANCET editorial that asserted that female education, rather than family planning, should be advocated for prevention of maternal deaths in sub-Saharan Africa. Family planning can prevent maternal deaths in 2 ways. The 1st is prevention of pregnancy among women at high risk of complicated pregnancy and delivery, including illegal abortion. The 2nd is simply prevention of pregnancy and, thus, exposure to complications. If only women who say they want no more children had no further births, an estimated 33% of maternal deaths in developing countries would be prevented. In reality, the effect of family planning might well be greater, since it plays an essential part in reducing mortality from illicitly induced abortion. Although improvement of education for Third World women will improve the quality of their lives, it is not likely to reduce maternal mortality. Once pregnant, 10-15% of women will have serious complicatons of pregnancy or delivery, no matter what the setting. The primary responsibility of health professionals is not socioeconomic development but prevention of maternal deaths resulting from lack of effective medical care. Interest in the issue is growing. In February, 1987, the World Bank, with the World Health Organization and the UN Fund for Population Activities, sponsored a meeting in Nairobi to launch the "Safe Motherhood Initiative." This initiative will contain a variety of activities. The authors hope that foremost will be those that act directly to prvent maternal deaths--prevention of unwanted pregnancies and early treatment of complications.