Around the world, approximately 18 million women of reproductive age die each year because of non-communicable diseases (NCDs), and two in every three deaths among women are due to an NCD. In fact, NCDs have been the leading cause of death among women globally for at least the past 30 years. And yet, women’s specific needs are often excluded from conversations about NCDs. They are underrepresented in clinical research and the effect of NCDs on women in particular is rarely considered. NCD-related symptoms during pregnancy are commonly misinterpreted or dismissed by clinicians.

We are in the decade of action, said Anneka Knutsson, Chief of the Sexual and Reproductive Health Branch at the United Nations Population Fund (UNFPA), at a recent Wilson Center event on midwives’ crucial role in achieving universal health coverage by 2030. The World Health Organization (WHO) has designated 2020 as the Year of the Nurse and the Midwife to celebrate the accomplishments and importance of nurses and midwives in providing not just maternal health care, but care across the lifespan. Currently, 22 million nurses and 2 million midwives globally deliver 80 percent of all healthcare services in low-resource settings. However, the world will need 9 million more nurses and midwives by 2030 to meet rising healthcare demands.

When childbirth takes place without skilled birth attendants or adequate emergency obstetric care, a woman may suffer from obstetric fistula. Women with fistula live with uncontrollable urinary and/or fecal incontinence, because a hole has formed between the birth canal and bladder or rectum. They have usually survived prolonged/obstructed labor, often lost their child to stillbirth, and frequently face severe social isolation and stigma. There are also now more and more women suffering from iatrogenic fistula caused by injuries during pelvic surgery, especially obstetric or gynecological surgery. Between 1 million and 2 million women currently need fistula repair, with thousands of new cases each year. However, most fistulas can be treated, enabling women to resume healthy, productive lives in their communities. Recognizing this, the United Nations has issued a call to end fistula by 2030.

In the quarter century the Wilson Center’s Environmental Change and Security Program has been pondering the issues for which it’s named, the world’s demographic future has been wobbling. A key concern of analysts: How many people will farmers need to feed in 2050? Mainstream projections have teetered between 8.9 billion and 9.8 billion, amounting to an increase of between 13 and 21 percent over today’s 7.7 billion. This significant variation in projections is rarely acknowledged by prognosticators. Many simply round up today’s latest guess and state confidently that there will be 10 billion people in 2050—though just a few years ago, the number most confidently stated was 9 billion.

“Non-communicable diseases have been the leading cause of death for women for at least the past 30 years but are often underreported and undertreated,” said Priya Kanayson, Policy and Advocacy Manager at NCD Alliance at a recent Wilson Center event on the impact of non-communicable diseases (NCDs) on maternal health. The event marked the official launch of the Maternal Health Initiative’s CODE BLUE series, developed in partnership with EMD Serono, a business of Merck KGaA, Darmstadt, Germany. Globally, in 2018, 73 percent of deaths among women were due to NCDs, amounting to 18 million women of reproductive age dying per year due to NCDs. The compounding effects of NCDs complicate women’s experiences in many unseen ways, and the rise and gravity of NCDs pose a growing and often overlooked challenge to maternal health worldwide.