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In countries around the world, many people nurture the same dream: to eventually have children and start a family. It's a dream that's only possible with access to good health care — including the care of a doctor who helps plan for a family and provides safe pregnancy and delivery care. But many couples in the developing world don't have that luxury. In fact, more than 120 million women want to plan their families but have no access to modern contraception.
Tragically, poor women are extremely vulnerable to illness, disability and even death due to lack of access to comprehensive reproductive health services. It may seem hard to imagine, but a woman in Ethiopia is more likely to die in childbirth than graduate from the sixth grade.
This isn't the way it has to be. Studies back up what CARE has seen in the field: When you have access to comprehensive reproductive health services, you can choose when and how many children you will have and you can have them safely.
While poor families often want more children than richer families, they are also more likely than their wealthier neighbors to have more children than they say they want. Several factors contribute to this phenomenon: lack of access to reproductive health services, unequal decision-making power between men and women, and inadequate information. High-quality reproductive health services could help overcome these barriers and should consist of:
- Access to family planning services for all who want them
- Health care during pregnancy and childbirth
- Treatment and prevention of sexually transmitted infections, such as HIV/AIDS
- Addressing gender inequalities like access to service and violence against women
Goals and Solutions
During the 1990s, a series of international conferences documented why women make up 70 percent of the world's poorest people. While there are several factors that work together to make that statistic a reality, one of the clear underlying causes of poverty is poor reproductive health among women.
With access to comprehensive reproductive health services, women are less likely to die in pregnancy, likely to have healthier children and better able to balance their family and work life. Despite these proven benefits, current spending on reproductive health programs worldwide is little more than half of the $17 billion necessary to adequately address the need.
We know what to do — we just need to make it happen. The United States needs to address the funding gap between current expenditures on reproductive health and what is necessary to meet the needs of women, children and families in the developing world.
CARE Success Story: Sauni
In some areas of Nepal, such as the Bajura region, local religious principles dictate that women are unclean during birth and after, and must separate themselves from the rest of the family for 11 to 28 days. To observe this custom, mothers traditionally give birth alone in their cowshed, cutting and tying the umbilical cord themselves - often using farm instruments. Predictably, about one Nepali woman in 20 dies while giving birth.
Two-year-old Rajkala is lucky, though. Her mother, Sauni, participated in one of CARE's reproductive health projects after losing her first child when she gave birth alone. Rajkala's parents attended family health classes in their village, which emphasized the importance of sanitary conditions for childbirth. As a result, Rajkala was born inside the house with a trained birth attendant who used a safe delivery kit. Now that Sauni is pregnant with another child, she and her husband plan to do the same again.
Standing outside her family's cowshed, Sauni holds Rajkala in her arms. "She won't have her babies here," she says, indicating the shed. "This place is only for the animals."
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