Reproductive Health Supplies

Over the past three decades, the world has made substantial progress towards improving reproductive health and slowing population growth, but many challenges remain. Most significantly, maternal and child deaths are unacceptably high. Every minute of every day, a woman dies in pregnancy or childbirth and some 20 children die of largely preventable causes. Still more women are left ill or disabled by complications of pregnancy and delivery. In developed countries, one woman in 2,800 dies during pregnancy or childbirth. The situation is starkly different in the developing world where a woman’s lifetime risk of death from maternal causes is 1 in 60. The risk can be even greater among rural, poor and uneducated women.

A mother’s well-being greatly impacts the health of her children. Women who are in poor health or are poorly nourished are less likely to receive prenatal care, more likely to experience complications in pregnancy and childbirth, and have babies who are less healthy. They often cannot provide adequate care, diminishing the chances their children will survive and thrive. Studies show that when a mother dies after giving birth, her newborn baby has a much lower chance of surviving in his or her first year. Children who do survive a mother’s death are less likely to receive adequate nourishment and health care. But when women have access to family planning, they tend to space the births of their children—giving all members of the family a greater chance of survival and good health.

Women's lives are saved when abortion is legal; unsafe abortion is preventable. Yet it is estimated that 68,000 women—seeking to terminate pregnancies—die from unsafe abortion every year, and millions more suffer complications. Of the estimated 210 million pregnancies that occur each year, about 46 million end in induced abortion. More than 18 million of these abortions are performed under unsafe circumstances every year. The consequences of unsafe abortion impose an additional burden on already-scarce hospital resources in many developing countries. Even where the procedure is legal, often health system shortages, poverty and misconceptions about the laws keep abortion unsafe. Where abortion is legal, it must be safe and accessible. Where abortion is heavily restricted, laws and policies should be eased or lifted on the grounds that doing so is necessary to reduce the high rate of maternal death.

Teenage girls are more socially and physiologically vulnerable to poor reproductive health, including acquiring HIV/AIDS and other STIs. They are at greater risk of obstructed labor and complications during delivery and are less likely to obtain prenatal care and to have the means to safeguard the health of their infants. Children born to mothers under the age of 18 have a greater chance of dying before age five, compared with births to mothers aged 20 to 34.

Comprehensive reproductive health programs provide life-saving interventions such as education about STIs, including HIV. AIDS kills people at the height of their reproductive and productive years, with devastating consequences for families, communities and national economies. In sub-Saharan Africa, where HIV infection rates are the highest in the world, condom use is lowest—at one percent among married couples. With growing numbers of infections among women due to the increase in heterosexual transmission of HIV, women account for 55 percent of all infected people in sub-Saharan Africa. The threat of HIV/AIDS has also heightened the need for programs that help women and men—and especially young people—strengthen their communication and negotiating skills.

In many places, HIV/AIDS testing, counseling and treatment sites are separate from other reproductive health services—often due to funding mechanisms rather than realities “on the ground.” This can mean missed opportunities to educate those seeking family planning on how to protect themselves from STIs, as well as providing access to voluntary family planning methods to those getting tested for HIV. In the face of the AIDS pandemic and the spread of other STIs, efforts to educate the public and promote condom use are critical.

Keeping modern reproductive health supplies—particularly modern contraceptive methods including condoms—consistently in stock has been challenging for many health facilities. Funding lapses, logistical difficulties, and misguided policies such as the global gag rule have conspired to create a growing gap between demand and procurement for these life-saving supplies. The United Nations Population Fund (UNFPA) has estimated that the funding gap could grow to U.S. $737 million by 2015. The global gag rule on U.S. population funding has effectively cut off contraceptive supplies from going to those who want and need them.

Gender inequities, sexual coercion, and violence by intimate partners undermine women’s sexual and reproductive autonomy and jeopardize their health and well-being. Women who lack sexual autonomy often are powerless to refuse unwanted sex or to protect themselves from unintended pregnancies, STIs and HIV. The reproductive health field is attempting to more adequately address the conditions of people’s sexual lives by training health workers and strengthening negotiating skills in both women and men. At the community level, efforts to bring about more equitable gender relations are ever more common. However, women living in areas of civil conflict are at particularly high risk of violence, unintended pregnancy and STIs.