In 2008 UK spending on Mother’s Day gifts may have amounted to as much as UK£1.6bn,  while last year it was estimated that consumers in the United States would spend as much as US$16bn.

This contrasts sharply with spending on basic life-saving care for mothers in much of the global south – with some countries spending less on all health services per head of population per year than some people will spend on their Mother’s Day bouquet.

With just 3 years left to meet Millennium Development Goal 5a (reducing the maternal mortality ratio by 75% between 1990 and 2015), there is still a long way to go. As many as 90% of women in some countries still give birth with no skilled birth attendant and have no access to emergency obstetric care if complications arise.

Reproductive Health Matters is dedicating its May issue to the subject of maternal mortality and asks whether the rhetoric of ‘safe motherhood’ is finally being matched by resources and action. Articles cover, for example:

An analysis of unsafe abortion differentials by age in developing countries which finds that younger women, especially adolescents, are disproportionately at risk of accessing unsafe abortion.

An investigation into maternal deaths in Madhya Pradesh, which finds drastic shortfalls in both antenatal and maternity care and questions the impact of government schemes to incentivise access to health facilities during birth.

An analysis of Demographic & Health Survey data for Egypt and Bangladesh which finds that improvements in antenatal care to be found in many countries are not matched by improvements in post-partum and post-natal care – still grossly neglected areas.

An article on the role of delaying care on maternal mortality and morbidity, which explores the importance of understanding women’s ‘road to death’ by combining the three delays framework and the ‘near miss’ approach. The challenges we face in trying to meet the Millennium Development Goal for maternal mortality are enormous, but as the authors of this paper note, the biggest obstacle to change is neglect and discrimination:

‘Understanding maternal deaths as a consequence of neglect implies the recognition that it is due to the disadvantaged position of women in society, including with regard to their reproductive rights. Only women experience the inherent risks of reproduction; this is a matter of sexual difference. However the lack of appropriate reproductive health care is a matter of gender discrimination and a consequence of a social system “based on the power of sex and class”. Gender discrimination occurs in all stages of women’s lives: preference for boy children, neglect of care for girls, poor access to health, and maternal mortality. The death of a woman due to pregnancy complications is not only a biological fact; it is also a political choice that is amenable to change and within human grasp. It depends above all upon political will.’1

The journal will be published in print and online in May 2012

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1. Pacagnella RC, et al. The role of delays in severe maternal morbidity and mortality: expanding the conceptual framework. RHM 2012; 20(39). In press.

guest blog by Lisa Hallgarten