Response: Ki-Moon's "Making Motherhood Safer"

(Please pardon the sound of the broken record in the background as I type.)

This morning's Herald-Tribune picked up a piece, beautifully written with the best of intentions, in the Opinion pages. The editorial called "Making Motherhood Safer" was penned by Ban Ki-Moon, the Secretary General of the United Nations. Ki-Moon sheds light upon the human rights crisis of women dying in childbirth around the world, in as high a percentage as 1 in 8 in some nations (i.e. Sierra Leone). He describes the struggle to find proper nutrition, the disparity in working hours and income, and the lack of trained attendants. These problems are very real, very scary and must be corrected. I wholeheartedly applaud the actions the United Nations and our own Government have taken, such as the UN Millenium Development Goal 5 and this year's Global Sexual and Reproductive Health Act. There are organizations that are on the ground today (e.g. Bumi Sehat Foundation International, All African People's Development and Empowerment Project) that are actively working to educate and offer women safe and gentle maternal health services. The rates of death in childbirth in these countries is absolutely unacceptable and demands and deserves the utmost priority of every government within the United Nations from which Ki-Moon writes.

However.

Ki-Moon also writes, "We (in the United States) know how to save mothers' lives. Some simple blood tests, a doctor's consultation and someone qualified to help with the birth can make a huge difference. Add some basic antibiotics, blood transfusions and a safe operating room, and the risk of death can almost be eliminated." These things most certainly do save lives in America, and no one doubts that childbirth is safer here than it was over a century ago. But the risk of death is very, very far from being eliminated. On the contrary, it has been steadily increasing since the 1980's, and now there are at least forty--yes, forty--countries in the world that lose fewer mothers than we do, yet we spend more on maternity care (by far) than any other nation in the world.

Sure, mothers in countries like Austria, Greece, Norway, Spain, Sweden, Switzerland, and the United Kingdom fare better than ours do, but so do mothers in Bosnia and Herzegovina, Slovakia, Slovenia, Estonia, Latvia, Lithuania and many more. And this is comparing our rates as a nation (currently 13.3 deaths per 100,000 live births, over three times our Healthy People 2010 goal). If you divide our nation by demographic, the numbers are staggering in places. For example, African American mothers in New York City die eight times more frequently (83.6 deaths per 100,000 live births). Not Sierra Leone, not in Somalia, not in Azerbaijan or Aceh or Haiti or Bangladesh. In New York City.

Why? Why are our rates soaring? Amnesty International has developed a task force to answer this question, and has issued the comprehensive Deadly Delivery: The Maternal Health Care Crisis in the USA. They took their findings to Washington this week in a Congressional Briefing, calling for a Department of Maternal Health under the Health and Human Services umbrella. I strongly support this proposition. We need and must demand accountability for states to accurately report the numbers and causes of maternal deaths (Florida is among the few that require this information on our death certificates). We need and must demand universal prenatal care, appropriate intervention during childbirth, and frequent postpartum visitation. Should a Department of Maternal Health be established, it may as well be subtitled the Office for Homeland Security; for that is the message our government would be sending our mothers. You are safe here. This is America.