Mother and newborn deaths cry out for attention

Every year, 2.9 million newborn babies worldwide die from mostly preventable causes, but a few simple steps can save lives, doctors say.

Starting Wednesday, Prime Minister Stephen Harper hosts a three-day global summit in Toronto called Saving Every Woman Every Child: Within Arm's Reach, which aims to shape future collaborations to improve the health of women and children.

An estimated 289,000 women died in 2013 from complications in pregnancy and childbirth, down from 523,000 in 1990, according to the World Health Organization. 

But given current trends, the agency says most countries will not achieve the target of a 75 per cent reduction that the international community pledged for from 1990 to 2015.

Dr. Jean Chamberlain Froese is the executive director of Save the Mothers, which works to reduce the numbers of mothers dying in childbirth through education of professionals in the developing world.

Her goal is to have the professionals themselves bring about a culture change so mothers can have a dignified and safe delivery. If not, Chamberlain Froese said, women will vote with their feet and stay home, where complications can be deadly for both the woman and her baby. 

Chamberlain Froese worked in Uganda for nine years and in Yemen for five years. She's also the director of the international women's health program at McMaster University in Hamilton.

About 15 per cent of pregnant women will have a life-threatening complication, regardless of where in the world they are. The difference, Chamberlain Froese said, is that while mom and baby may have a rough road in Canada, they have access to a hospital where blood, anesthesia for C-sections and medication are standard and high-quality care is available around the clock.

Those differences explain in part why Uganda loses 6,000 women to childbirth complications every year compared with about 20 per year in Canada.

In the lead-up to the summit, WHO pointed out five ways to save more lives:

• Quality care before, during and after childbirth.
• Safe blood supplies.
• Essential medicines such as antibiotics and oxytocin.
• Contraception and safe abortion services.
• Every death counted and its cause recorded.

Make births count

Last week, the medical journal The Lancet published a series of papers that outline the progress and challenges to improve newborn survival around the world.

The research was led by Prof. Joy Lawn of the London School of Hygiene & Tropical Medicine and Save the Children, U.K., with Prof. Zulfiqar Bhutta at Toronto’s Hospital for Sick Children and the Aga Khan University in Karachi, Pakistan.

The first step is to recognize there’s a problem, Bhutta said.

"One of big issues around global newborn survival is that nobody counts them, nobody measures them. A large proportion of babies, newborn babies worldwide, actually don't even have a birth certificate,” he said in an interview with CBC Radio’s Metro Morning.

After the birth counts, Bhutta called for accountability on improvements as well as low-cost solutions that can make a difference to newborn survival such as:

• Breastfeed early and exclusively.
• Give birth in a clean environment.
• Make sure there’s a clean delivery kit for every birth.
• Take good care of a newborn’s cord.
• Keep small and preterm babies warm.

Bhutta estimates the running cost to provide these measures at reasonable coverage across the world, particularly in low and middle income countries, is less than $6 billion a year or less than a couple of dollars per baby.

That’s not a huge investment to make, not only for survival but also to increase development potential and economic growth of countries, he said.

The research shows that although there’s been an overall reduction in the number of child deaths worldwide, most of the reductions have taken place for older children. About 44 per cent of all deaths in children under five are in the first month of life, according to The Lancet.

It’s the deaths of the youngest, those who take a breath but die because women and babies aren’t cared for adequately around delivery time, that cry out for attention and solutions, Chamberlain Froese said.

"These babies are dying not because we lack the knowledge to save them; they are dying for a lack of attention and investment," philanthropist Melinda Gates co-wrote in the journal with Rwanda's health minister, Agnes Binaghawo.

Harper set maternal and newborn health as an international priority in 2010 at the Muskoka Initiative during the G8 summit in Ontario’s cottage country.