More than 60 percent of preventable maternal deaths and 45 percent of newborn deaths take place in countries affected by recent conflict, natural disaster, or both. Yet as Sarah B. Barnes, Project Director of the Maternal Health Initiative, observed at a recent event hosted by the Wilson Center and UNFPA, in collaboration with the Inter-agency Working Group on Reproductive Health in Crisis (IAWG) and White Ribbon Alliance, “the leading causes of both maternal and newborn death occurring in humanitarian settings are considered to be preventable if managed by skilled providers and adequate resources.”

Reducing maternal mortality is key to promoting population health. It is also a main priority of the UN General Assembly’s Sustainable Development Goals. And the reasons for concern are clear. Globally, 800 women and 6,500 infants die during pregnancy and birth every day. More than 94 percent of these deaths occur in low-and-middle-income countries (LMICs).

“When women can decide on the timing and spacing of their births, are treated with respect, and offered quality of care across the life course—they are not only able to survive, they, their families, and their communities are able to thrive and flourish. By directly and indirectly contributing to women’s empowerment, midwives are contributing to strengthen economic and productive and equitable societies,” said Dr. Julitta Onabanjo, Director of the Technical Division at the United Nations Population Fund (UNFPA), New York, at a recent event hosted by UNFPA as part of the 66^th Session of the Commission on the Status of Women. Midwives and midwifery experts convened to discuss the important role that midwives play in the improvement of gender equality, women’s economic empowerment, and climate justice.

Greater than one third of all women experience mistreatment during facility-based childbirth. Mistreatment, particularly in humanitarian settings, may include verbal or physical abuse, poor patient-provider rapport, a lack of information about maternal and newborn health (MNH) services for both pregnant women and providers, lack of privacy within facilities, challenges with receiving informed consent from women for medical procedures due to language and cultural barriers, and denied or delayed care. Such mistreatment can stem from historical tensions between populations seeking care and health workers (both foreign and local) as well as systemic mistreatment of providers who are burned out and possibly carry their own biases. Evidence shows that some women delay seeking care, or avoid care entirely because of social fears stemming from negative stigma or negative perceptions of their situation. 

Since its onset, the impact of the COVID-19 pandemic on maternal mortality has been a question of great concern. And yet, few empirical attempts have been made to capture the potentially profound impact of the pandemic on maternal deaths, particularly in resource-limited settings.

“Regardless of income level, regardless of education level, Black women, Native women, women who live in rural areas are more likely to die or be left scared or scarred from an experience that should be safe and should be a joyful one; and we know a primary reason why this is true – systemic inequities,” said Vice President Kamala Harris during her opening remarks at the first-ever White House Maternal Health Call to Action Summit on December 7, 2021. Members of Congress and maternal health advocates gathered to discuss the importance of addressing racial disparities and systemic challenges in maternal health through national policy.

“The current pandemic is straining human resources, disrupting supply chains and service delivery, and negatively impacting service seeking among women and girls in countries across the globe,” said Sarah Barnes, Project Director of the Wilson Center’s Maternal Health Initiative. She spoke at a recent event, co-hosted by the UN Population Fund (UNFPA), on unintended pregnancies during the COVID-19 pandemic. The increasing rates of unintended pregnancies during the pandemic have exacerbated the vulnerabilities of many women, said Anneka Knutsson, Chief of the Sexual and Reproductive Health Branch at UNFPA.