No woman should die while giving life: Maternal mortality – the unfinished business of the MDG era

Author: Dunia Mekonnen Tegegn
Human rights lawyer, Ethiopia

Maternal mortality is one of the shocking failures of development and a dreadful social injustice. According to recent UN official figures, 536,000 women die every year during pregnancy and birth. This is one death every minute. Out of the 536,000 maternal deaths, 99% are experienced by women in developing countries. The highest maternal mortality rates are in Africa; with a lifetime risk of 1 in 16. Maternal death is often the result of policy decisions that directly or indirectly discriminate against women. Maternal death is also often an indication of inequalities between men and women in their enjoyment of the right to the highest attainable standard of health. Below I illustrate how other rights are either implicated by or essential in combating maternal mortality.

Right to life

A women’s right to life is the most obvious right violated by avoidable death in pregnancy or birth. Usually the right to life is used to refer only to the right to due process of law before someone is subjected to capital punishment. However it is important that the right to life is understood broadly to include protection from arbitrary and preventable loss of life.

Right to liberty

The right to liberty and security of the person are essential guarantees to an individual’s integrity and also to the right of maternity. In its historical context, this right is related to the prevention of arbitrary arrest or detention. The Beijing Platform of Action recognises women’s right to liberty and urged states to consider reviewing laws containing punitive measures against women who have undergone illegal abortions as this constitutes a violations of their rights. In addition to this, criminalization of contraception, voluntary sterilization and abortion also constitute a violation of Women’s right to liberty and security. These rights are violated when a state denies women access to means of fertility control, the absence of which consequently results in untended pregnancies, which in turn has an adverse effect in increasing maternal mortality.

Right to marry and found a family

The right to family is not a limited right which only applies to women during pregnancy and child birth. This right should also extended to the right of women to enjoy the highest standard of health throughout their life span. It should be stressed here, that maternal death is not only a problem to women but also to their children as it has an adverse impact on children left behind who need their mothers, especially during their early age. Additionally, the right to found a family must include obligations of states to ensure that girls are matured enough for marriage and childbearing by prohibiting child marriage through laws and by taking relevant measures when these laws are violated. In the event of complications and during child birth, states have a duty to make certain that women are able to get the proper treatment so that they can enjoy their right to family life.

Right to the highest attainable standard of health

Generally speaking, effective and equitable health systems are essential towards reducing maternal mortality. The highest attainable standard of health entitles women to services in connection with pregnancy and the post natal period and to other services and information on sexual and reproductive health. Polices that are informed by right based approaches to health are likely to be more equitable, sustainable and effective.

Pregnant women have the right to health and to essential health services which are free where necessary. States also have the duty to ensure women’s right to safe mother hood by providing emergency obstetric care. These services should be provided to the maximum extent of available resources.

Right to equality and non-discrimination

Unlike men, women not only have to fear human rights violations because they are human beings but also because of their gender. International human rights law confers women with equal rights independent of motherhood. Article 1 of CEDAW entitles women protection against discrimination in both the public and private domains. The right to equality requires that we treat the same interests with no discrimination but it also implies that we treat different interests in ways that adequately respect those differences. It should be emphasized here that the greatest threat to women’s reproductive health is their inability to exercise this right. Maternal mortality does not only reflect the violation of women’s right to health but, it also indicates the systematic equality and discrimination women face daily during their entire life span.

Rights relating to benefits of scientific progress including to health information and education

The right to seek, receive and impart information is fundamental to the realization of reproductive health. There is also a direct relationship between girls’ access to education, information and the reduction of maternal mortality. CEDAW is explicit in its various recommendations and provisions that women have the right to information and counseling on health and family planning. In the traditional context, this right has been understood as a right which imposes a negative obligation to governments by prohibiting interference in its exercise. However, in the current understanding the right extends to taking positive measures. In relation with reproductive health governments have an obligation to provide essential information relevant to the reproductive cycle. Many women lose their lives during child birth because they have no information on obstetric complications and or the means of preventing such complications or where to access health care services for these complications. Lack of accurate and age appropriate sex education can be mentioned as one factor which aggravates the problem of maternal mortality. In addition to this type of information education is important for women to differentiate customary practices that are detrimental to child birth.

About the Author:
Dunia Mekonnen Tegegn is a human rights lawyer from Ethiopia. She has been working as a Human Rights Officer at OHCHR EARO and as Program Officer on ending violence against Women at UN Women country office. Dunia has also worked with the Ethiopian Women Lawyers Association and UNICEF Ethiopia as a seconded staff. She has also been an organizing member of human rights moot court competitions in Ethiopia and has represented her country in the 14th African Human Rights Moot Court Competition in Pretoria. Dunia is a graduate of law from Bahirdar University and also hold a masters degree in human rights from Addis Ababa University College of Law and Governance with an advance certificate on humanitarian law and policy. Dunia has co-edited and published a book on “Unleashing African resilience: Pan African renaissance in the new Africa century” and “Security and empowerment: African women in the 21st century.”