Pregnancy, labour and delİvery: A journey to be made safe

Statistics on maternal mortality show the persistent inequity existing for women of the developing world and remain the indicator with the greatest gap between the western, industrialized world and many countries in Africa, Asia and Latin America, where more than 95% of all deaths occur. The difference between the more and the less fortunate women is abysmal: in the west, death rates fluctuate around 10 per lOO'OOO, whereas in certain parts of Africa they reach l'SOO per lOO'OOO. While, in 1990, there were no deaths attributable to pregnancy, labour or delivery in Iceland, Luxembourg and Malta, in certain areas of Africa the lifetime risk of dying because of pregnancy-related causes, is 1 in 7. The World Bank has reported that, in developing countries, maternal mortality is the most important health problem for women aged 15-44, accounting for 18% of the total burden of disease.
In addition, maternal mortality must be recognized as the tip of an iceberg made of human suffering because of sequelae of maternal morbidity; WHO has estimated that between 15 and 20 million women each year suffer long-term disabilities because of child bearing and delivering. Although no firm statistics exist, it is guessed that vescico vaginal fistulae alone affect over 2 million young women of Africa and Asia and that only a fraction of those are repaired.
Maternal mortality and morbidity should not be ranked with other diseases and set aside because of low figures compared to malaria or tuberculosis, because child bearing is not a disease. It is the means through which every species, including the human, propagates. For this reason a global ethical consideration imposes an obligation upon society to avoid those almost totally preventable deaths.
FIGO, the International Federation of Obstetrics and Gynecology, has recently decided to make the journey through pregnancy, labour and delivery a safe one for all women; to this end, it is mobilizing the obstetricians gynecologists of the world to join the fight against maternal mortality and morbidity, utilizing the skills existing in its member societies in the industrialized world to help those from the most affected countries. We hope that all obstetricians-gynecologists will join this fight.