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Wednesday, March 10th, 2010 - One comment

It affects us all: Maternal healthcare

Though many politicians in the U.S. believe that maternal healthcare is unnecessary, maternal healthcare should be universal and guaranteed for every woman.

Last year, the US debate over health reform took an ugly turn over the issue of maternity care, when Senator Jon Kyl of Arizona blithely declared “I don’t need [it].” Senator Debbie Stabenow of Michigan replied: “I think your mom probably did.”

The media furor over this exchange has long since died down. But I personally cannot stop thinking about it. This exchange raises issues far too important and enduring for just a flash of media attention, issues essential to the search for common ground on abortion and the fostering of universal human rights. Pro-choicers in the US pointed out Kyl’s hypocrisy as someone who calls himself “pro-life.” Many pro-lifers condemn the same contradiction.

Problem of maternal healthcare

There is plenty of scientific evidence to back up the outrage against Kyl. According to data gathered by United Nations agencies like United Nations Population Fund (UNFPA), the US ranks 29th globally in infant mortality and 41st in maternal mortality, in large part because of racial and class disparities in health care access, and because of US providers who have economic incentives not to follow the best practices available.

Healthcare for mothers: A basic right

In support of universal health care, Childbirth Connection points out that 85% of US women give birth at some point in their lives and 4.3 million do so in any given year. Twenty-three per cent of hospital discharges are of childbearing women and newborns, who account for a far larger proportion of total hospital charges than any other group of patients. As well as involving so much of the population and the health services sector, maternity care offers unique opportunities to improve the life courses and health outcomes of mothers, fetuses, and newborns.

Globally embraced documents of the universal human rights movement also support the outrage against Kyl, even though the last two of these have yet to be ratified by my country, shamefully enough. The Universal Declaration of Human Rights identifies “medical care and necessary social services” as human rights, and “motherhood and childhood” as “entitled to special care and assistance.”

CEDAW, the Convention of the Elimination of All Forms of Discrimination Against Women, asserts the responsibility of states to “ensure to women appropriate services in connection with pregnancy, confinement and the post-natal period, granting free services where necessary.” According to the Convention on the Rights of the Child, states have a responsibility to implement every child’s right to ‘special safeguards and care…before as well as after birth.” This includes the “diminish[ment] of infant and child mortality” and the ensuring of “appropriate pre-natal and post-natal health care for mothers.”

A way of reducing abortion?

As a pro-lifer who affirms all of these universal human rights, I also recognize another dimension to guarantee maternity care for all, something that concerns pro-choicers, too, for different but often overlapping reasons. Along with being a right on its own, universal, guaranteed maternity care is also, not one whit less importantly, an indispensable way to alleviate situational pressures upon women towards abortion. In particular, it is helpful to reduce pressure upon the poor, including the global poor, women who have disabilities or who carry disabled babies, women of color, immigrants and refugees, and students.

According to the Guttmacher Institute, 57% of US women who have abortions are economically disadvantaged. Lack of access to free/affordable health care, including family planning services and both maternity and pediatric care, is both a cause and consequence of economic disadvantage. This also helps to explain, for example, the fact that African American women have five times as many abortions as white women.

Consequences on the poor

The consequences of denying maternity care are even more dire for the global poor. Although the withheld funds have thankfully been restored, my own government quite recently withheld $34 million per year from UNFPA, the world’s largest force for proper maternity care and other solutions to abortion, like family planning. (Contrary to what some US pro-lifers believe, UNFPA has an official policy of not promoting abortion.)

This defunding may have caused nearly 800,000 induced abortions, as well as 2 million unsought pregnancies, 4700 maternal deaths, nearly 60,000 cases of serious maternal illness, and over 77,00 neonatal and child deaths.

Even in such a wealthy nation as the US, many women’s and children’s own life and death stories also validate the right of maternity care. Although my poverty was nothing like the deep poverty of so many in the world, I vividly remember how challenging it was for me in 1986-87 as a student with disabilities to hold onto the expensive private insurance plan my daughter and I so desperately needed throughout and beyond that medical and emotional roller coaster of an unplanned, high-risk pregnancy.

Two decades later, when my college student daughter became pregnant herself, she and her baby–who turned out to have a life-threatening but correctable gut impairment– were also subjected to uncertain coverage. My grandson is a year and a half now, but we are *still* fighting the plan’s refusal to pay for his mom’s emergency asthma treatment in the eighth month of pregnancy.

And yet we were all the “lucky” ones. I can’t imagine how any of us would be alive today without the access to proper health care we somehow managed to have. I shudder to think what might have happened otherwise. This inter-generational story is but one deep source of my conviction that US society, not only Senator Kyl, must stop already in its dismissal of maternity care, a matter of life and death, as some lightweight thing that one can access only via fluke.

A universal problem

To regard maternity care as simply an option that “I don’t need” is to wash one’s hands of collective responsibility for mothers and babies and therefore to have complicity in those situational pressures towards abortion. This responsibility extends beyond those who are mothers or wish to become mothers, to every member of society. Countries that regard maternity care as everybody’s business and everybody’s concern, such as the Netherlands, have abortion rates that are a small fraction of the high US rate.

Every single one of us grew inside the body of a woman who needed access to proper health care to keep both herself and her baby alive and well. I only need to look at the faces of my daughter and grandchild and my own in the mirror to know that universal, guaranteed maternity care is a moral and political imperative everywhere. A rich country like mine must do all it can to make guaranteed maternal healthcare a reality not only for its own residents, but all women and children throughout the world.

This post is a response to the post Are pregnant women expendable?

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The views expressed in this blog-post are solely those of the author.

Comments (1)

Isobel Hoskins
Thursday 11th March, 2010, 10:10am

Its not by chance that maternal mortality reduction is in the Millennium development goals! The Guttamacher Institute has a recent report on maternal health "Adding it up: the costs and benefits of investing in family planning and maternal and newborn health." (http://www.guttmacher.org/pubs/AddingItUp2009.pdf)

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Guest Editor

Mary Krane Derr

Writer, Poet, Multi-Issue Nonviolence Activist, Co-Founder, All Our Lives

About

I am a US citizen of largely Irish and Polish political & economic refugee descent. I am a writer, poet, and multi-issue nonviolence activist, as well as a former maternal/child welfare social work clinician. With Jen Roth I am co-founder of All Our Lives, http://www.allourlives.org, a reproductive peace group. My interests & concerns are wide-ranging but include disability rights; women's rights; anti-racism; global poverty; animal and environmental concerns; and the power of the world's diverse religions and spiritualities, as well as secular thought, to cooperate in fostering social responsibility.

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