New Internationalist

Facts

Issue 303

THE FACTS OF LIFE
- AND DEATH

Giving birth is a dangerous business. One woman dies every minute from causes related to pregnancy and childbirth.

Thousands more suffer temporary or permanent disabilities. Much of this is due to poverty. In developing countries 20-45% of women of childbearing age do not have enough to eat and nearly two-thirds of pregnant women are anaemic, suffering the long-term effects of ill-health. 1

In many countries basic health services do not exist, often because of cuts made by governments trying to impose structural-adjustment programs. The cost of basic reproductive health for all women has been estimated at $17 billion each year. 2 This amounts to just $2.90 per person per year - or less than the world spends in one week on arms.

Population paradoxes

At the end of 1997 there were nearly 6 billion people in the world. Global population is currently growing at the rate of about 80 million people each year (down from the early 1990s when the figure was 85 million). The UN's medium projection for 2025 puts the figure at 8.04 billion and for 2050, 9.37 billion. [image, unknown]

BUT: [image, unknown] The prospect of a decrease in population producing a better world with more resources for everyone is not as straightforward as it seems. A person in the North consumes 8 times as much energy as someone from the South and 1.3 billion people in the developing world live on less than a dollar a day. 3
Women everywhere are having fewer babies. The decline is steepest in the North but is also mirrored in the South. Because there are so many women of childbearing age, lower fertility rates have an impact on population growth.

[image, unknown] Countries like China with more than a billion people will have a big impact on world population even if the fertility rate stays low.

[image, unknown] The highest fertility rate is in sub-Saharan Africa. But since the population there is relatively small (593.7 million) the increase will have little effect on total world population.

Unmet need

No contraceptive method is 100% effective. Nonetheless, access to, and knowledge about, contraception is essential if women are to give birth safely to the number of children they want.

Nearly 60% of men and women use contraception. But an estimated 350 million couples lack the information or access they need to a range of methods and services. Worldwide, between 120 and 150 million women who want to limit or space future pregnancies are unable to do so.

At 67%, North America has the highest usage of modern contraceptives while Africa has the lowest at 15%, although these figures do not include traditional methods.

[image, unknown]

[image, unknown]

Sexually transmitted diseases

There are more than 333 million new cases of sexually transmitted diseases (stds) every year. Of these nearly 6 million are aids/hiv, 90% of which occur in developing countries. (Barrier methods of contraception which reduce the risk of hiv account for less than 5% of contraceptive use in the South and 25% in the North). Worldwide, women contract stds at more than 5 times the rate of men. stds are the second-most important cause of diseases for women aged 15-44 in developing countries, after deaths and illnesses related to pregnancy and childbirth. They are most frequent in young people aged 15-24. 5

New cases of curable sexually transmitted
diseases among adults (millions) 1995

[image, unknown]

Maternal mortality 1990 2
Number of maternal deaths for every 100,000 live births

Women at risk

The number of women who die for every 100,000 live births varies from an average of 27 in developed countries to an average of 479 in less-developed nations. For each death, another 13 women suffer from a less serious threat to their health. Most maternal deaths are in the Majority World. An African woman is 500 times more likely to die of pregnancy-related causes than a woman in Scandinavia. However, poor or minority women everywhere are most at risk. For example in the US black women face a risk nearly four times as high as white women. 5

Small lives

Young children who suffer the death of a parent are more at risk of dying themselves. In South Asia, the death of a mother puts a child's life in danger more than the death of a father. For a girl, the death of her mother increases the chances of dying by 400%.

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Unsafe abortions

There are an estimated 20 million unsafe abortions each year and more than 70,000 abortion-related deaths, most of them in the Majority World. An unknown but much larger number suffer infection, injury and trauma. Where abortion is illegal, the number of women resorting to unsafe abortion increases - and so does the danger of them dying or being injured.

Estimated number of deaths from unsafe abortions 1995 2
[image, unknown]

1 Patricia Smyth, Women and Health (Zed Books, London 1992)
2 The State of World Population 1997 (UNFPA)
3 Human Development Report 1997 (UNDP)
4 Demographic and Health Surveys Program, MacroInternational, US. Figures for India from India National Family Health Survey.
5 World Health Organization: An overview of selected curable sexually transmitted diseases (WHO 1995)
6 World Health Organization 1993. Other sources: Progress of Nations (UNICEF 1997); State of the World's Children (UNICEF 1997); World Health Report 1997 (WHO).

BACKGROUND PHOTO: MICHELLE DRY

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