Maternal, Newborn, and Child Health (MNCH)
More than 303,000 women die annually from complications during pregnancy or childbirth. For every maternal death from these complications, at least 30 other women suffer serious illness or debilitating injuries. The millennium development goals seek to reduce maternal mortality by 75% by 2015, but the maternal mortality rate is declining only slowly. Almost all deaths from complications of pregnancy or childbirth—99%—occur in developing countries. In sub-Saharan Africa, a woman’s maternal mortality risk is 1 in 38, compared to 1 in 3,700 in developed regions.
In addition, a woman’s survival is critical to that of her children. Every year, more than 1 million children are left motherless; children who have lost their mothers are up to 10 times more likely to die prematurely than those who have not.
The situation is not hopeless. 80% of all maternal deaths are preventable through access to education and contraceptives, timely prenatal and postnatal care, skilled birth attendance during delivery, and emergency care to deal with post-partum complications.
Given the link between maternal and infant mortality, if we can save the life of the mother, we can likely save her child as well. Since 1990, we have cut child mortality rates in half. Even so, more than 5.9 million children die before the age of five; 44% of those children die in the first month of life. These children die of pneumonia, birth complications, diarrhea, malaria, and malnutrition. We can do better. We can halve these numbers again by 2030 with interventions like breastfeeding, vaccines, and oral rehydration.
Healthy Timing and Spacing of Pregnancies (HTSP)
What do we mean when we say we support the “healthy timing and spacing of pregnancies"? We mean enabling women and couples to determine the number and timing of their pregnancies, including the voluntary use of methods for preventing pregnancy, not including abortion, that are harmonious with their values and religious beliefs. The term “family planning” is often used synonymously with this concept.
More than 220 million women around the world who want to avoid pregnancy do not have access to effective contraceptives, counseling or services. The global partnership known as FP2020 was established in 2012 to guide the international effort to meet this need for 120 million women by the year 2020.
Healthy timing and spacing of pregnancies can dramatically improve the health and chances of survival of both women and children. In the words of journalist Michael Gerson, “family planning is a pro-life cause.”
The benefits include the following:
Healthy Timing of Pregnancies
High-risk pregnancies include those of women under the age of 18 or over 34. The context of the developing world, with poor health systems, increases the risk. In many developing nations, child marriage is a common practice--in Ethiopia, one out of five girls is married by the time she is 15. Yet girls younger than 15 are five times more likely to die from complications during pregnancy or childbirth than women in their 20’s. At the other end of the spectrum, older women with five or more children are 1.5 to three times more likely to die from complications of pregnancy and childbirth than women with two to three children. With support, women and families in developing nations can make informed decisions about becoming pregnant in light of the risks.
Healthy Spacing Between Pregnancies
When spaced two years apart, children are healthier and more than twice as likely to survive infancy. The time between pregnancies also allows the mother to provide the benefits of breastfeeding longer. It also allows her to spend more time with each child. Optimal spacing contributes to each child’s physical, mental, and emotional development.
Reduction of Abortions
Every year, there are 210 million pregnancies worldwide. Of the women with those pregnancies, it is estimated that 85 million do not want to be pregnant. About half of those pregnancies, 42 million, end with an induced abortion. Among women who obtain abortions, more than 67,000 die because of abortion-related injuries, and millions more suffer complications and long-term injuries. Abortion-related injuries account for 13% of maternal deaths worldwide.FP2020 Metrics Group projects that if an additional 120 million women are reached with contraceptives and education by 2020, over 116 million unintended pregnancies and 52 million abortions would be averted.
Keeping Girls in School and Allowing Mothers to Work
Healthy timing and spacing of pregnancies result in families that are able to pursue education and to provide for their needs, making it one of the most cost-effective and powerful strategies to empower women and improve their lives. Women who are empowered to make choices about childbearing are more likely to get more education and job experience, and contribute to the economic health of their families and communities. Research has shown that personal savings and investments increase when working parents have a number of dependents that is more manageable, given their means.
Family Planning: Strategy Overview, The Bill & Melinda Gates Foundation
Maternal, Neonatal & Child Health: Strategy Overview, The Bill & Melinda Gates Foundation
Family Planning and Reproductive Health Briefs, Christian Connections for International Health
Healthy Timing and Spacing of Pregnancy, World Vision
The Potential of Long-acting Reversible Contraception to Decrease Unintended Pregnancy, Association of Reproductive Health Professionals
Prevention of Unsafe Abortion, World Health Organization
Common Sense and Common Ground, New Evangelical Partnership for the Common Good