WOMENAID INTERNATIONAL

The Fight for Women's Lives

Parliamentarians join forces 
against Maternal Mortality
by Dr. Maria Cristina Calderon

Fatal complications from pregnancy and childbirth result in the deaths of over 500,000 mothers every year, one woman every minute.  Roughly 99 per cent of these fatalities occur in developing countries, where health services fail to reach the poorest women.  It is estimated that more than two-thirds of these deaths could be prevented with proper health care. 

Parliamentarians have a vital role to play in the fight to improve maternal health and enable mothers to give birth under the care and guidance of modern family planning services.  As spokespersons for their constituencies, parliamentarians represent a potent expression of public will.  They are able to serve as women's beacons of hope, focusing popular support for women's health into a political force for change.  Moreover, the strength of their influence gives parliamentarians a responsibility to act.  Mothers around the world depend on them to lead the fight for women's lives. 

The Andean Region, Bolivia in particular, exhibits the highest level of maternal mortality in the Western Hemisphere.  Where the most critical threat to a healthy pregnancy stem from inadequate medical care, there exists in the region a wide range of social, cultural and legal hazards that imperil the health - and life- of women as well.  In the arena of legal change, parliamentarians play a fundamental role. 

A mother's death is the result of a sequence of discrimination suffered by women during their entire life.  From infancy, they cannot enjoy the same educational opportunities as men.  The proper feeding and nutrition of female children is neglected out of an intense favouritism of male children.  An anaemic or undernourished pregnant woman, for example, runs a high risk of haemorrhaging at the moment of childbirth, one of the most common causes of maternal mortality.  Women do not have the same job opportunities, receive less pay for the same work and, when they become pregnant or are already a mother, are not able to claim maternity or nursing leave from their work.  They are most likely to be fired.  For fear of losing the job that enables them to feed their children, and unwilling to bring another child into world of misery and poverty, they seek an abortion. Under adequate technical and sanitary conditions, abortion can be practiced safely, but when illegal and unsafe, it becomes a hazardous and even deadly procedure. 

The Andean Safe Motherhood Conference, held in Santa Cruz de la Sierra, Bolivia (29 March - 2 April 1993), signalled the level of international concern for maternal mortality rates in that region, and sounded the alarm for legislative action and advocacy efforts.  The parliamentary session organised by Family Care International, "Legislacion y Mortaladid Materna : Accion Parliamentaria en Salud Reproductiva" ("Legislation and Maternal Mortality.  Opportunities for Parliamentary Action in Reproductive Health") on March 31 1993 brought together political leaders in the women's field, as well as presidents of commissions on health, social welfare and maternal nursing.  Participants attending the session came from Bolivia, Columbia and Ecuador. 

Actions required at the parliamentary level include the following: 

Legislators must understand the international agreements recognised by their respective countries, as well as the commitments made by each nation to women's health, reproductive rights, and the reduction of maternal mortality. 

The Convention to Eliminate All Forms of Discrimination Against Women, CEDAW, offers a suitable starting point for legislative action.  This centrepiece international treaty specifically targets women's health issues, but is ultimately a document advocating basic human rights. 

Despite the fact that all Andean countries have adopted the Convention, there is evidence that legal discrimination against women persists on a wide scale. The realities of the legal system can have serious repercussions for maternal health. Considering the subtle forms of discrimination present in regional legal structures, the fulfillment of relevant international obligations is vital to progress in maternal health. 

Parliamentarians of signatory countries must abide by the provisions of the Convention, enacting appropriate regulations to ensure that non-discriminatory policies will be effectively enforced.  Existing national laws must comply with the Convention, and no new laws may be enacted in violation of its spirit. 

Safe motherhood is closely linked to the fullest exercise of women's reproductive rights. A woman's pregnancy should be hoped for and timely, that is, the prospective mother should be in emotionally and physically healthy at the time of the inception. 

Family planning services and information must be available at affordable cost for both men and women of low-income families, starting from adolescence, in rural as well as urban districts.  Information and services should aim at educating young people in sexual health, enabling them to become familiar with their bodies, genital organs, fertility cycles, sexually-transmitted diseases, and the diverse manifestations of human sexuality.  Post-natal and post-abortion services for women must be available as well. 

Given the high incidence of rapes, which result in unwanted pregnancies, the following must be taken into account: Increasing street safety should be a high policy priority. 

Women may often be force to have sexual relations with their husbands or boyfriends against their will. These rapes are usually accompanied by violence or blackmail by the perpetrator to silence the rape victim.  To increase women's safety within the household, such behaviour ought to be strictly penalised. 

Appropriate legislation should seek to ensure that there is an adequate maternal health system in place, so that women can give birth in clean and safe conditions, by making access to emergency, pre- and post-natal services easily available. 

The social role of motherhood should be clearly recognised.  Legislation must therefore make it easy for parents to care for their children during child-rearing, granting maternity leave for mothers, providing for kindergarten facilities and inducing men to sharing more fully in parental responsibilities. 

Public and private international agencies such as the Inter-American Parliamentarian Groups (IPG), Family Care International (FCI), the International Planned Parenthood Federation (IPPF), PAHO/WHO and UNICEF provide technical assistance on these issues to Government officials and legislators alike.  Budget allocations for social issues, which have suffered sharp cutbacks in most countries in recent years, must be substantially increased if the strengthening of local capacity on population and family planning issues is to be at all effective. 

PARLIAMENTARIANS' ACTION

On Family Planning and Contraception: 

  1. To amend any law that limits the access to family-planning services to adolescents and adult women, by requiring the consent of parents or spouses; 

  2. To introduce sexual education courses for boys and girls since the early years of schooling; 

  3. To make family-planning counselling as well as post-delivery and post-abortion services available on demand; 

  4. To overrule legal norms restricting access to information on family planning to the general public; 

  5. To bring family-planning services to low-income communities, especially in rural areas, where most high-risk population is concentrated; 

  6. To increase national budget allocations for family-planning programmes; 

  7. To raise the minimum age to marry without parental consent.  

On Abortion : 

  1. To provide timely and adequate treatment for complications related to spontaneous or induced abortions; 

  2. To amend national laws in order to decriminalise abortion, bearing in mind the large number of clandestine abortions as well as the high mortality rate resulting from them. 

On the need to improve women's socio-economic situation to give them equal rights and opportunities. 

  1. To recognise the value of women's domestic work in the National Accounts; 

  2. To guarantee women's access to land ownership, credit and education; 

  3. To legislate women's maternity leave, making sure that no woman is dismissed during pregnancy or as a result of it; 

  4. To mandate the establishment of kindergarten facilities in the workplace; 

  5. To make every woman eligible for social-security benefits; 

  6. To promote the sharing of responsibilities for child-rearing and domestic activities among spouses; 

  7. To ban gender-based, discriminatory stereotypes in textbooks and advertisements, so that women are not portrayed in an inferior or derogatory way; 

  8. To promote massive information and sensitisation campaigns on women's rights. 

On violence against women, the most outrageous form of gender discrimination: 

  1. To streamline and expedite procedures to control and sanction sexual harassment in the workplace as well as domestic violence, especially that among spouses and partners, establishing mandatory programmes to re-educate the perpetrators; 

  2. To set up special police units especially sensitized and trained to deal with domestic violence, and reform the criminal justice system so as to make it easier for the victim and her relatives to report any abuse; 

  3. To sponsor the establishment of shelters for victims of social and domestic violence; 

  4. To promote a nation-wide debate on the issue of violence against women, seeking to raise the public consciousness on its status as a criminal act; 

  5. To support the efforts of the Organization of American States (O.A.S.) to enact an Inter-American Convention to prevent, sanction and eradicate all forms of violence against women. 

OTHER RECOMMENDATIONS 

To set up interdisciplinary commissions to formulate a legislative agenda on family-planning issues, with the participation of women's and private groups with substantive knowledge and expertise on women's reproductive rights; 

To amend national laws in order to bring them in line with international agreements ratified by each country; 

To increase funding for comprehensive health and welfare programmes targeted at women; 

To establish multi-sectoral parliamentary committees with representatives from such Commissions as Women, Education, Communications, Finance, Population and Health, to co-ordinate and oversee progress on implementation of family-planning and reproductive health programmes; 

To sponsor high-level meetings to co-ordinate policy implementation in the health sector, especially as regards reproductive-health policies; 

To evaluate the possibility of creating a Ministry of Women's Affairs, to be vested with executive authority over all issues affecting women; 

Lastly, it is highly recommended that parliamentarians take it upon themselves to periodically prepare National Reports on "legislative, judicial, administrative and other measures" adopted by Member Countries, to be submitted to the U.N. Secretary General every four years in accordance with the provisions of the Convention on the Elimination of All Forms of Discrimination Against Women (Art.19). 

Translated by Alejandra Meglioli 

Source :Inter-American Parliamentary Group on population and development

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