Maternal deaths in developing countries are often the ultimate tragic outcome of the cumulative denial of women's human rights.Women are not dying because of untreatable diseases. They are dying because societies have yet to make the decision that their lives are worth saving. Maternity is a social function and not a disease. When women are risking death to give life, they are entitled to have their own right to life and health protected. Societal attitudes of looking at women as means and not ends have resulted in the denial,of women's rights to essential maternity services. A signal of hope is that safe motherhood is now on the world agenda as one of eight Millennium Development Goals. The global community of obstetricians has a major responsibility to help make motherhood safer for all women.

The Lancet Sexual and Reproductive Health Series aims to stimulate awareness and action among decision makers, policymakers, medical researchers and other professionals on emerging and significant SRH issues, while serving as a tool for evidence-based advocacy and advancing research on preventable illness and death. Due to recent Lancet publications on neonatal survival and maternal health and a forthcoming series on HIV/AIDS, these topics are not addressed in this series.

This publication explores knowledge, attitudes, and perspectives on pregnancy, delivery, and fistula from 31 country-level needs assessments conducted in 29 countries in the Campaign to End Fistula (see inside back cover for the complete list). Experiences of women living with obstetric fistula, their families, community members, and health care providers are brought to light. This information represents important research on the social, cultural, political, and economic dimensions of obstetric fistula, drawing attention to the factors underlying maternal death and disability.

Ensuring women affordable, accessible, and safe health services is a key obligation of the government of Kenya. However, as this report vividly illustrates, Kenya’s health care sector suffers from longstanding systemic and widespread problems that impair the delivery of quality care. While this report focuses specifically on women’s experiences with reproductive health services, it also provides a lens through which to look at the Kenyan health care system in general. In doing so, this report documents ongoing violations of a range of human rights and the difficulty seeking redress for these violations.

Today "more than 536,000 women die during pregnancy and childbirth every year. That is one every minute, or 10 million per generation."2 This toll has remained almost unchanged since 1987. This last piece of information points to the real tragedy of maternal mortality: it is a poor women’s issue.3 Maternal mortality is thus not only a question of underdevelopment but of social inequity and injustice—both between and within countries. It is also a question of lack o political will, and of little advancement in terms of women’s health and human rights. What these data blatantly conveys is that we have either not done enough, or that we have been doing it wrong. It is redundant to say, then, that we are far from reaching MDG5, and thus the rest of the Millennium commitments.

This chapter addresses the duty of governments to ensure women’s safety throughout pregnancy and delivery. The chapter identifies the two principal components of this duty as obligations to: 1) guarantee women’s right to reproductive health care, and 2) guarantee the quality of maternal and reproductive care.

This report highlights a number of factors that inhibit the provision and availability of maternal health care in the country, which include: the inadequacy or lack of implementation of laws and policies, the prevalence of systemic corruption, weak infrastructure, ineffective health services, and the lack of access to skilled health-care providers. The separation of responsibilities for the provision of health care among the country’s three tiers of government both contributes to and exacerbates the harmful impact of these various factors.

Powerpoint Presentation of Maternal Mortality in Peru Law.

This report identifies and also describes the policies and practical investments that can improve access to sexual and reproductive health (SRH) services and information. Based on country experiences from around the world, the report shows how SRH analyses and interventions can be integrated into MDG-based national development strategies, as recommended by the UN Millennium Project.

This study demonstrates that women in Herat Province, Afghanistan have an extraordinarily high risk of dying during pregnancy and childbirth and the highest maternal mortality ratio in the world outside of Africa. It shows that prenatal care, maternal health care facilities and trained health care personnel are virtually non-existent in the region and it provides evidence that violations of human rights contribute to preventable maternal deaths. These factors include access to and quality of health services, adequate food, shelter and clean water, and denial of personal freedoms such as freely entering into marriage, access to birth control methods and possibly control over the number and spacing of children.

This report has set out to examine key strategies for achieving millennium development goals (MDG). Taking steps such as: Increasing couples' access to modern contraception to prevent unintended pregnancy; Improving the quality and accessibility of postabortion care; and Expanding access to safe, legal, voluntary and affordable abortion care.

With support from the Averting Maternal Death and Disability (AMDD) Program, CARE began the FEMME Project in 2000 to increase access and utilization of emergency obstetric care (EmOC) services for the approximately 48,000 pregnant women in the northern provinces of Ayacucho. Methods: The project targeted 5 facilities with a comprehensive package of interventions designed to improve capacity to provide quality EmOC services and to promote a human rights approach in health care. Key program activities included improvements in infrastructure, human resources capacity development, development of service standards and protocols, quality improvement activities, and promoting a rights-based approach to health. Results: By the end of the project, northern Ayacucho had 6 functioning EmOC facilities: 3 comprehensive (including a non-FEMME project facility) and 3 basic. This exceeds the UN minimum recommendation of 5 EmOC facilities per 500,000 population. Other changes in the UN process indicators indicate an increase in quality and utilization of EmOC services. Met need for EmOC increased significantly from 30% in 2000 to a high of 84% in 2004. Case fatality rates declined and the number of maternal deaths in the entire region declined. Conclusion: CARE’s work in Ayacucho made an impact on policies and programs related to EmOC throughout the region. Within CARE, project experiences have supported maternal health programs particularly in the Latin American/Caribbean region.

This report is yet another wake-up call to Zimbabwe's neighbors and all U.N. member states for urgent intervention to save lives and prevent more deaths. These findings add to the growing evidence that Robert Mugabe and his regime may well be guilty of crimes against humanity.

This article has two objectives.  First, it will give an overview from a public health standpoint of the scope and determinants of maternal morbidity and mortality, together with the issues involved in their detection, treatment, and measurement.  Second, it will explain how the UN Guidelines for monitoring national programs can be used as human roots tools to monitor a state's compliance with respect to aspects of the right to health under various international treaties.

In 2004, the Center for Reproductive Rights launched a global initiative to promote the use of strategic litigation for the advancement of women’s reproductive rights worldwide. Inspired by the use of public interest litigation in India as a tool for advancing social justice and promoting human rights, the Center organized the first ever training on reproductive rights for lawyers in India in 2006, in collaboration with Human Rights Law Network. It was at this meeting that the potential for developing constitutional litigation to address maternal mortality through the use of international norms and comparative law was discussed in great depth for the first time. The discussions that took place at this training, and which followed later at various meetings and consultations, provide the inspiration for this report. We hope it will be used as a tool to help establish a protective legal environment based on human rights principles and norms that will enable women to exercise their right to survive pregnancy and childbirth and lead healthy and productive lives. We further hope that this report will serve as a useful resource for lawyers, judges, academics, activists, students and others who seek to challenge and dismantle discriminatory norms and practices that contribute to gender inequality in Indian society – an inequality that is continuously manifested in the huge number of preventable and foreseeable maternal deaths that occur each year.

During the UN high-level event on the Millennium Development Goals in September 2008, IIMMHR called upon global leaders to recognize maternal health as a human right.

This call to action, which is endorsed by the steering committee of the International Initiative on Maternal Mortality and Human Rights, highlights human rights violations underlying maternal mortality and the actions needed to address those violations to make safe pregnancy the priority it must be.

This document compiles key statements from the medical community, international agreements, and the World Health Organization to assist health professionals in taking action to prevent maternal mortality from unsafe abortion.

This briefing paper discusses the international legal standards for the rights to life, health, non-discrimination and reproductive self-determination and identifies governments’ corresponding duties to ensure women’s enjoyment of those rights. It provides global illustrations of the toll that inadequate health-care delivery, pervasive discrimination and denials of reproductive decision-making take on women’s lives and health. It concludes with a brief discussion of the gap between the international community’s stated commitments to promoting maternal survival and its actions to that end thus far.

This report approaches maternal mortality as a deprivation of basic human rights. It considers the manner in which laws, policies and pervasive social norms contribute to maternal mortality in Mali and calls for concerted, urgent action on the part of the government and the international community to ensure women’s safety on their journeys through pregnancy and childbirth.