Maternal Death And Illness Now Recognized As Pressing Human Rights Concerns
On 17 June 2009, the United Nations Human Rights Council adopted a resolution recognizing maternal death and illness as pressing human rights concerns. Ximena Andión Ibañez, International Advocacy Director at the New York-based Center for Reproductive Rights and one of the key actors in organizing for this resolution, spoke with Masum Momaya about the resolution and its implications.
On 17 June 2009, the United Nations Human Rights Council adopted a resolution recognizing maternal death and illness (MDI) as pressing human rights concerns.
The World Health Organization defines maternal mortality as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. 
More than 1500 women and girls die every day from complications related to pregnancy and childbirth; that translates to around 550,000 annually.
Ninety-nine percent of maternal deaths worldwide occur in developing countries where women often cannot control whether, when, and whom they marry; may be subject to early marriage; and may be forced to bear children “too early and too often.” These conditions, paired with lack of access to basic family planning methods needed to delay, space, or limit childbearing, lack of access to safe abortion services, and lack of access to emergency obstetric care contribute to the ongoing toll in women’s lives and health. 
Ximena Andión Ibañez of the Center for Reproductive Rights shares her thoughts on this landmark recognition.
Despite numerous campaigns, relatively little progress has been made in reducing maternal illness and death (MDI) over the past few decades. Why is this the case?
On one hand, governments have not prioritized the elimination of maternal mortality in their public health agendas. There is a lack of political will, and this is reflected in the lack of human and financial resources and the lack of monitoring and accountability mechanisms to address this issue.
On the other hand, programs and policies developed by governments to combat MDI mostly focus on the medical aspects; however, a solely medical approach is not effective. MDI is related to a series of socio-economic and cultural factors such as gender inequality and gender-based violence that need to be addressed to effectively combat MDI.
The coalition of groups working at the Human Rights Council stated that, in spite of significant United Nations’ consensus documents (e.g. the Beijing Platform for Action) recognising the need to increase efforts promoting the health and rights of women and girls, it has taken nearly two decades “for the UN’s main political human rights body to take this important step.” Why has it taken so long to pass this resolution?
MDI is still seen by many as “an unfortunate reality” or at best just a “development issue,” not a human rights issue. Thus, getting the Council member States to affirm that women have the right to survive pregnancy and childbirth was a challenge.
What is the significance of naming this as a pressing human rights concern?
It is significant for multiple reasons. First, it acknowledges that women’s human rights to life, health, equality and non-discrimination are violated when preventable maternal deaths and illnesses occur. MDI is now recognized to be a grave human rights violation like torture and disappearances. Thus, governments are obligated to take effective measures to eliminate preventable MDIs.
The resolution stresses that a human rights-based approach to reducing MDIs is more effective and sustainable. What does this mean and what are the implications?
Taking a human rights-based approach, practitioners and policymakers focus not only on medical causes but also on socio-economic factors related to gender inequality.
Additionally, with this approach, there is a focus both on the outcomes and the process, which entails placing women’s equality and well-being at the center and treating them as bearers of rights. This means that women participate in the design, implementation and evaluation of the programs and policies, which gives them agency and ownership.
Also, a human rights-based approach calls for paying special attention to marginalized groups of women and understanding the multiple forms of discrimination that they experience in accessing health care services and accordingly, providing quality, affordable, culturally-appropriate health care services.
Finally, this approach ensures the existence of monitoring and accountability mechanisms where governments and others can be hold accountable for the failure to guarantee a woman’s human rights to survive pregnancy and childbirth.
What are some specific service provisions that could stem from this resolution?
Ideally, it is fundamental to guarantee access to quality emergency obstetric care; skilled birth attendants; education, information and confidential counseling on sexual and reproductive health; family planning services, including a wide range of contraceptive methods; and access to safe abortion.
Overall, it is also important to improve access to the underlying determinants of health including water; sanitation; food and education.
The issues of safe abortion, contraception and family planning are not specifically mentioned in the document adopted by the Human Rights Council. But do references to various existing government declarations imply that ensuring accessibility of safe abortion services, at least where legal, is part of what states have been asked to do?
The resolution calls States to combat ALL preventable maternal deaths. One of the causes of maternal mortality is unsafe abortion so states have to take measures to prevent the mortality and morbidity caused by unsafe abortion. One of the ways to do this is guaranteeing access to safe abortion where legal and also reviewing and revising their abortion laws to allow abortion at least under certain circumstances.
What do you think the resolution will mean for organizations and clinics that are serving women at the community-level? Are civil society organizations now charged with the task of ensuring that governments live up to their commitments? What suggestions do you have for how they should go about this?
First, this resolution can be used as a basis to generate dialogue at the community level between authorities, policymakers, health-care providers and community members.
Also, I think that the resolution is a very powerful tool for advocacy. To make it a real tool for change, though, it is important that civil society organizations use it to ask their governments to take concrete actions to improve the situation of maternal health.
One thing that people can do is find out whether their government co-sponsored the resolution or not (see note below). If they did, congratulate them for their political will, and if they didn’t, hold them accountable. People can ask their Ministries of Health what measures they will take to comply with the resolution, for example how much money will be allocated to maternal health services or how community participation will be ensured in program development and policymaking to combat MDIs.
Download the Complete Resolution
Learn about the International Initiative on Maternal Mortality and Human Rights
Read speeches from a 5 June 2009 expert panel on Maternal Mortality
Join the Center for Reproductive Rights’ Facebook Causes page on Maternal Deaths
Understand how the global economic crisis is impacting family planning services
The following States co-sponsored the resolution: Australia, Austria, Belgium, Bolivia, Brazil, Bulgaria, Canada, Chile, Colombia, Congo, Croatia, Cyprus, Czech Republic, Denmark, Dominican Republic, Ecuador, Estonia, Finland, France, Germany, Greece, Guatemala, Honduras, Ireland, Israel, Italy, Liechtenstein, Lithuania, Luxembourg, Maldives, Mali, Malta, Mexico, Monaco, Nepal, Netherlands, New Zealand, Nicaragua, Norway, Panama, Peru, Poland, Portugal, Romania, Rwanda, Slovenia Spain, Sri Lanka, Sweden, Switzerland, Thailand, Turkey, Ukraine, United Kingdom and United States.