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Marc Bryan-Brown/Women in the World

Mothers at Risk

Fighting Maternal Mortality

Midwives and other medical experts speak out on how to end the staggering loss of life occurring in the act of giving birth.

Every two minutes a woman dies in childbirth or complications from pregnancy. It’s a sobering statistic, to be sure; staggering, even, considering that 99 percent of those deaths are preventable. Like so many ills in the world, maternal mortality can be linked to poverty and lack of education and resources. And when those issues are addressed, maternal mortality goes down.

As proof, consider Edna Adan Ismail, founder and CEO of Edna Adan University Teaching Hospital. Having grown up in British Somaliland, Ismail won a scholarship to study as a midwife in Britain. When she returned to Somaliland in 1960, she was the first—and only—midwife in the entire country. “I was where the buck stopped,” she told the audience at the “Breakthroughs in the Fight Against Maternal Mortality” panel, sponsored by Merck, at the Women in the World summit Friday afternoon at New York’s Lincoln Center.   

In the 54 years that Ismail has been in practice, serving women from all corners of Africa, she has been an integral part in reducing the maternal mortality rate by 75 percent. It wasn’t an easy process, as she had to learn on her own how to deal with the major causes, including preeclampsia, pulmonary embolism, and postpartum hemorrhage.

“I would have women show up who had been having seizures for four or five days; they were suffering kidney and liver failure and were almost dead. When I asked why they hadn’t come earlier. They would tell me they had been on the road that long.” Ismail said.

Fortunately for the women of Somaliland, Ismail not only has trained plenty more midwives to serve Africa’s women, but also has opened her own hospital. For most of Africa and the developing world, though, there is no time to wait for hospitals to be built, or even for doctors to be trained. “So we must do the next best thing,” insisted Ismail. “We must educate women to be midwives.”

Maternal mortality is not only an emerging-nation problem. In fact, the U.S. has recently fallen from 41st to 50th place, the worst among developed nations, reported Soledad O’Brien, the panel’s moderator. Two women who mercifully survived near-death experiences, Cheryl Gambrill and HRH Princess Sarah Zeid, joined the panel in their roles as advocates for education and early intervention.

Gambrill, an executive assistant at Baltimore Healthy Start, which provides mobile support to pregnant women and new mothers in part thanks to the Merck for Mothers program, was in her 20s when she went into labor at just 25 weeks. The delivery was so problematic that her mother was called in and asked to choose between saving her daughter or her grandson, who was eventually born at just 1lb. 6 ½ oz. Gambrill’s boss, Alma Roberts, president and CEO of Baltimore Healthy Start, was also on the panel and noted the particular needs of poor urban areas in the U.S., particularly in minority neighborhoods. “African-American women are four times more likely to die in childbirth, and African-American children three times more likely.”

Sarah Zeid had just given birth to her third child when she experienced an embolism. “I could not imagine what it would be like for my children to not have their mother,” she said.

While there is still so much to be done to address maternal mortality and, as Zeid said, “often more heartbreak than breakthroughs,” important progress is being made.

With the Merck for Mothers initiative, the drug manufacturer plans to spend $500 million over 10 years to address the issue. One output of this initiative is the development of a form of Carbetocin, reported Merck Chairman and CEO Ken Frazier, whose own wife had a near-death experience in childbirth. “Carbetocin can address postpartum hemorrhage,” he said, “but one of the issues is that it has to be refrigerated. We’ve developed a version which can be stored at any temperature, which will allow us to deploy it to Africa and other developing nations where refrigeration is a huge problem.”
 
  

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