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The high risks faced by women in pregnancy and childbirth in under-resourced countries were the focus of maternal health expert Distinguished Professor Caroline Homer AO’s moving keynote address at a special Burnet lunch to mark 2018 International Women’s Day.
It was announced at the lunch that Professor Homer is moving to Burnet Institute mid-year to take a leading role in our Maternal and Child Health program.
Previously Professor Homer had been the Director of the Centre for Midwifery, Child and Family Health at University of Technology Sydney and a researcher, midwife and educator.
She is also Assistant Secretary General (Midwifery) for the Global Network of World Health Organization (WHO) Collaborating Centres for Nursing and Midwifery, and an NHMRC Principal Research Fellow.
Professor Homer said she was joining Burnet because of its holistic approach to health solutions, and to take part in its flagship Healthy Mothers, Healthy Babies (HMHB) program.
Image: Professor Suzanne Crowe AM, Board Member Helen Evans AO, and Associate Professor Freya Fowkes
“I really like the combination of basic science, health service strengthening, epidemiology and public health. It’s one of the few places that brings all of those together in a very cohesive way,” she said.
“I’m really looking forward to working on the HMHB initiative going forward and I’d really like to see that grow and be replicated in other places, and to understand better how to use the evidence from that to inform policy and practice.”
She told the lunch gathering that nearly 830 women die every day due to complications of pregnancy and childbirth. In Australia 23 women die every year from such complications; in Papua New Guinea (PNG) this figure was more than 1500, mostly from post-birth bleeding or infection, unsafe abortion and hypertension.
Lack of skilled care was the main obstacle to better health for mothers in many countries, she said.
“Many women will not see a health professional through their pregnancy,” Professor Homer said.
“The sad reality is most maternal deaths can be prevented. Last year the World Health Organization recommended eight antenatal visits; in PNG getting to four is almost impossible.
“The WHO forecast an 18 million shortage of qualified health workers by 2030. That’s over twice the seven million shortfall we estimated a couple of years ago.”
About 16 million girls aged between 15 and 19 give birth each year, with adolescent mothers accounting for 10 per cent of all births in lower and middle income countries.
The maternal mortality ratio (the annual number of female deaths per 100,000 live births related to pregnancy) in developing countries is about 240; in richer countries it is about 12.
“Maternal health mirrors the gap between rich and poor, everywhere,” she said.
She said the solutions to high maternal mortality rates in countries such as PNG, where a woman is 80 times more likely to die as a consequence of pregnancy and childbirth than in Australia, were not complicated.
“Access to affordable care before, during and after birth. Access to quality obstetric and midwifery care including safe abortion care, contraception, nutrition education support and breastfeeding.”
Under-resourced countries need a quality midwife in every village, with medication, a phone and a motorbike to reach help if needed, she said.
“Midwives are a cheap workforce - once they’re out there with their facilities, they can deliver 87 per cent of the interventions.
“When we invest in women and girls, no one will be left behind.”
Deputy Program Director of Maternal and Child Health (MCH), Associate Professor Freya Fowkes, explained Burnet’s extensive MCH program which has 70 projects spanning 14 countries, and described her own experience of giving birth compared to a new mother she had recently helped in Myanmar.
Image: Professor Suzanne Crowe and Dr Michelle Scoullar chat with longstanding Burnet supporters Lady Anna Cowen and Ms Kate Cowen
“Here in Australia with a child who needed intensive care, I saw one very experienced consultant, 11 paediatric doctors and 18 different midwives. A woman in Myanmar would be lucky to come across one very skilled person to help her through her pregnancy and childbirth,” she said.
HMHB Principal Investigator, Dr Michelle Scoullar, said stories of maternal death were too common in PNG.
“Of our 17 staff members in PNG working on this program, all of them can name someone in their friends or family who has died in childbirth. That’s not OK, and we need to do something about that,” Dr Scoullar said.
International Women’s Day was honoured for the first time in Austria, Denmark, Germany and Switzerland on 19 March 1911, and the day is marked around the world on 8 March.
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Deputy Program Director, Maternal and Child Health