The real answer to reducing maternal mortality is not 'safe' abortion but better education, obstetric and midwifery care, CMF tells DFID

The Christian Medical Fellowship has now published its submission to the Department for International Development (DFID) Consultation on Maternal Health Strategy: 'Choice for women: wanted pregnancies, safe births'

The Government proposals have been criticised for appearing to link the provision of abortion services with international development aid as DFID says one of its key proposals is ensuring access to contraception and ‘safe’ abortions.

By contrast the CMF submission tackles the problem in an evidence-based way reviewing the real causes of maternal mortality and the interventions that have been shown in practice to reduce it.

It concludes that the real solution to maternal mortality is multi-level: addressing social attitudes, education and empowerment and good quality obstetric and midwifery care and better birth spacing.

Furthermore this is best achieved through positive engagement with religious leaders, communities and faith based organisations (FBOs).

The whole submission is available on the CMF website but its main points are as follows:

1. In the last two decades we have seen a marked reduction globally in maternal mortality from 500,000 deaths per annum to 350,000 per annum. The vast majority of these are still in the developing world.

2. The interventions that have reduced this mortality rate have been multi-level: addressing social attitudes towards women, pregnancy and child birth; providing education for girls and the empowerment of women; increasing access to good quality obstetric and midwifery care (in the local community and in accessible secondary care institutions); and providing family planning services to allow better birth spacing, etc. We hold that the evidence suggests that only such multi-level interventions will have significant or lasting success in tackling maternal mortality; and further, that strengthening health systems for maternal health will have collateral benefits for other areas of health need.

3. Positive engagement with religious leaders, communities and faith based organisations (FBOs) is vital, as they are not only significant providers of services, but also hold the key to challenging and changing social attitudes and values that can devalue women and their health needs.

4. Empowering women, and changing socio-cultural and religious values that disenfranchise women and girls and deny them access to healthcare and education, are priorities. This requires engagement with community leaders in general, and religious leaders and communities in particular, in their own terms and context, rather than imposing Western worldviews and values.

5. Single issue interventions are damaging to wider health needs in the long term. We advocate strengthening the broad range of health infrastructure and provision (both primary and secondary) in developing nations. This includes appropriate training (undergraduate and postgraduate), professional support for healthcare staff, and adequate provision of properly maintained equipment with appropriate supply chains.