Advancing Safe Motherhood through Human Rights

Do laws and policies facilitate or inhibit women’s access to reproductive health care and obstetric care? Most systems have core principles of medical law that protect the right to informed and free decision-making by patients, their privacy and confidentiality, the competent delivery of services, and the safety and efficacy of products.

Laws that obstruct women’s access to information and care can function as direct causes of maternal mortality. Preventing access to services are laws that criminalize medical procedures that only women request, and that may be indicated to save their lives and health, such as those that govern contraception and abortion. While often tied to social or religious concerns, these criminal laws put women at risk when they prohibit treatment necessary to save the lives of pregnant women.

Systems of health law and policies that restrict women’s reproductive choices are usually based on historical connections between sexuality and morality. Many restrictive policies reflect the idea that women’s sexuality and access to birth control endanger morality and family security.

Laws that entrench women’s inferior status to men and interfere with women’s access to health services seriously jeopardize efforts to reduce maternal mortality. These laws take a variety of forms, such as those that obstruct economic independence by impairing women’s inheritance, employment or acquisition of commercial loans or credit. Account should be taken of criminal laws that condone or neglect violence against women, and, for instance, of inequitable family, education and employment laws that deny adult women alternatives in life to marriage, or that condition women’s self-realization on marriage and motherhood.

The cumulative impact of such laws is often that daughters are seen to burden their families, that their deaths in infancy are inconsequential, and that they will remain in the home to serve other family members until marriage. On marriage, they will obey their husband’s families by rendering services and bearing sons. Accordingly, daughters will be given in marriage to men they do not choose, have no independent status or means while unmarried, conceive early and often in marriage, obediently protect family, social and cultural values before and in child rearing, and be vulnerable to violence and death if perceived to endanger family honour.

A necessary first step towards applying human rights to advance safe motherhood is an assessment of the scope and causes of unsafe motherhood in a particular community, based on available data sources, or on the collection of relevant new data. Where possible, maternal death should be investigated. A maternal death investigation should establish both medical and non-medical causes of death, and whether the death occurs in a hospital or at home. Several factors may influence the success of a maternal death investigation. It must be made clear that the purpose of the investigation is to find ways to reduce maternal mortality – not to find blame.

Account should be taken of criminal laws that condone or neglect violence against women, and, for instance, of inequitable family, education and employment laws that deny adult women alternatives in life to marriage, or that condition women’s self-realization on marriage and motherhood.

Laws and policies that obstruct free choice of maternity, and the availability of and access to services, should also be identified, along with laws that facilitate women’s empowerment and laws that obstruct women's empowerment.

*Reported by Adanma Ike