1. Raising Global Awareness: The Quest for Safer Childbirth in High Risk Countries Presented by Jennifer Moller BSN, RNC

2. Learning Objectives Present statistics on maternal mortality in the developing and underdeveloped world. Identify the major causes of maternal mortality. Examine the barriers to safe childbirth and prenatal care. Discuss the causes, impact and incidence of obstetric fistula. Introduce the Millenium Development Goals (MDG’s) and The Mother’s Index. Present a documentary film which chronicles a journey undertaken by a physician who experiences firsthand the perils of childbirth in Afghanistan.

3. “Each year, more than 500,000 women die from causes related to pregnancy and childbirth.” - UNICEF Sobering statistics……

4. Maternal Mortality Rates (MMR) Worldwide

5. According to the United Nations, a woman's chance of dying in childbirth in the United States is 1 in 4,800. In Ireland, which has the best rate in the world, it is 1 in 48,000. “One in eight women die in childbirth in Sierra Leone, the highest mortality rate in the world.” Spotlight: Sierra Leone

6. Spotlight: Afghanistan “Only 14 percent of births are attended in Afghanistan. One in nine women will die during childbirth or shortly after. Nearly all Afghan mothers will experience the loss of one child before its 5 th birthday.“ - UNICEF

7. “A girl in southern Sudan is more likely to die in childbirth than she is to gain a primary education.” – Nicholas Kristoff, NY Times, May 2010 Spotlight: Southern Sudan

8. “In Yemen, one in every three girls is married before the age of 18.”- UNICEF On September 13th, 12-year old Fawziya Abdullah Youssef died of severe bleeding while giving birth to a still-borne baby in Yemen. – CNN, September 14, 2009died Spotlight: Yemen Child bride dies of internal bleeding in Yemen SANAA Thu Apr 8, 2010 3:18pm EDT SANAA (Reuters) - A 13- year-old Yemeni girl died three days after marrying a man twice her age, due to internal bleeding following intercourse, a Yemeni human rights group and UNICEF said.

9. Spotlight: Bangladesh In rural Bangladesh, 69 percent of females are married before the age of 18, many of whom are married at 12 or 13. 21,000 women die annually during childbirth because only 13% of births have skilled attendance.

10. Causes of Maternal Death in the Developing World

11. Barriers to Safe Prenatal Care and Childbirt h Geography Lack of Resources Lack of Education Status of Women Cultural/Religious Beliefs Political Instability

12. Impact Increased infant mortality Perpetuation of female oppression Altered collective female psyche Dysfunctional family dynamics Loss of family revenue Increased population of orphans Physical disabilities  i.e. Obstetric Fistula

13. “Millenium Development Goals” UNDP 2000 MDG 1: Eradicate extreme poverty and hunger. MDG 2: Achieve universal primary education. MDG 3: Promote gender equality and empower women. MDG 4: Reduce child mortality. MDG 5: Improve maternal health. MDG 6: Combat HIV/AIDS, malaria and other diseases. MDG 7: Ensure environmental sustainability. MDG 8: Develop a Global Partnership for Development. MDG 1: Eradicate extreme poverty and hunger. MDG 2: Achieve universal primary education. MDG 3: Promote gender equality and empower women. MDG 4: Reduce child mortality. MDG 5: Improve maternal health. MDG 6: Combat HIV/AIDS, malaria and other diseases. MDG 7: Ensure environmental sustainability. MDG 8: Develop a Global Partnership for Development.

14. Bottom 10- worst places to be a mother 151. Equatorial Guinea 152. Eritrea 153. Sudan 154. Mali 155. DR Congo 156. Yemen 157. Guinea-Bissou 158. Chad 159. Niger 160. Afghanistan Top 10- best places to be a mother 1.Norway 2.Australia 3.Iceland 4.Sweden 5.Denmark 6.New Zealand 7.Finland 8.Netherlands 9.Belgium 10.Germany 28. United States The Mother’s Index Save the Children, 2010

15. How Can We Help? International Level Follow the G8 Summit this June. Follow the United Nations General Assembly meeting in September. Support a global action plan which is committed to accelerating progress on MDG’s 3, 4, and 5. Join a campaign that supports women and children. National Level Support the national health care policy. Make a commitment to becoming more politically aware. Join the ANA and CNA as well as your national affiliation. Pursue all forms of continuing education.

16. Paying the ultimate price…..

17. What the world needs…

18. Suggested Reading