Saturday, April 17, 2010

Lancet study on maternal mortality

According to new research data published in the Lancet the global level of maternal mortality declined substantially between 1980 and 2008. This study contradicts figures published by the UN the WHO and other UN agencies all of which have consistently reported that there has been little or no change in the numbers of maternal deaths over the period.

The study, Maternal mortality for 181 countries, 1980—2008: a systematic analysis of progress towards Millennium Development Goal 5 prepared by Christopher Murray and colleagues at the University of Washington in Seattle was funded by the Bill & Melinda Gates Foundation.

The study assessed 181 countries and used a combination of vital registration data including surveys, census data and autopsies to rank maternal deaths, which were classified as either early and late. Early deaths were defined as the death of women during pregnancy or childbirth or in the 42 days after delivery. Late maternal deaths were defined as being between 42 days and 1 year. The researchers estimate that the total number of maternal deaths dropped from around 526300 in 1980 to a level of approximately 342900 in 2008, a reduction of 35 percent over the period. The study additionally shows that 60,000 of the 2008 deaths related to AIDS rather than any maternity related factors. The researchers found improvements in many countries including China, Egypt and Ecuador.

The Study however also shows some surprising results.
First it is clear that decline shown by the study in maternal mortality would have been even greater but for inclusion of the HIV related deaths.

Second it shows that Italy not Ireland has the lowest maternal mortality in the world at 4 per 100,000 followed closely by Australia at 5 per 100,000 and with Austria, Ireland and Israel in joint third position at 6 per 100,000.

Thirdly it shows that in some first world countries maternal mortality has actually increased. The U.S. ratio for example rose to 17 per 100,000 in 2008 from 12 per 100,000 in 1980 and represents an increase of 42 percent on the 1980 figures. Looked at another way this shows that women giving birth in the United States die at more than four times the rate of those in Italy and more than double that of Britain at 8 per 100,000 which has remained virtually unchanged in the past 20 years. Some increases in the ratios were also noted in Canada, Norway, Austria, Denmark and Singapore.

Pro-abortion groups did their utmost during the negotiation of the millennium development goals MDG's to include a goal on reproductive health in order to prioritise abortion and access new funding sources. Despite their best efforts however their plans were defeated, pro-life efforts succeeded in ensuring that Development Goal 5 focused specifically on the reduction of maternal mortality only to the exclusion of the abortion agenda. The pro-abortion response to this has been their determination to find ways of including their pro-abortion agenda in MDG 5 and the main plank of of their strategy was the claim that maternal mortality levels were virtually static. The new survey is therefore unwelcome news for them as they prepare for a women deliver conference in Washington in June and the MDG review in September.

The New York Times in an article quote Dr. Richard Horton of the Lancet, who states he received pressure from maternal mortality advocacy groups not to release the new findings at this time.“I think this is one of those instances when science and advocacy can conflict,” he said.

Dr. Horton according to the article said the advocates, whom he declined to name, wanted the new information held and released only after certain meetings about maternal and child health had already taken place.

He said the meetings included one at the United Nations this week, and another to be held in Washington in June, where advocates hope to win support for more foreign aid for maternal health from Secretary of State Hillary Rodham Clinton. Other meetings of concern to the advocates are the Pacific Health Summit in June, and the United Nations General Assembly meeting in December.

“People who have spent many years committed to the issue of maternal health were understandably worried that these figures could divert attention from an issue that they care passionately about,” Dr. Horton said. “But my feeling is that they are misguided in their view that this would be damaging. My view is that actually these numbers help their cause, not hinder it.”