Use What Works

If you want to actually improve the health of women and children, contraception needs to be part of the discussion.

For two weeks now, controversy over women’s health has occupied both politicians and regular Canadians.

It started on January 26, when Prime Minister Stephen Harper announced his intention to make maternal and child health a priority at the upcoming G8 Summit, to be held in Canada this June. "As president of the G8,” he said, “Canada will champion a major initiative to improve the health of women and children in the world's most vulnerable regions." Harper called the deaths of more than 500,000 women each year during pregnancy and childbirth unacceptable. “What makes it worse,” he added, “is that the bulk of the deaths during pregnancy – experts claim as many as 80 per cent – are easily preventable.”

In a news conference a week after that announcement, opposition leader Michael Ignatieff called on the prime minister to include a comprehensive range of reproductive health services, including contraception and the termination of pregnancy, in his initiative. Ignatieff cited former U.S. policy under the Bush Administration that withheld federal funds from international agencies that supported abortion. "We don't want us to go that way," he said. "We want to make sure that women have access to all the contraceptive methods available to control their fertility because we don't want to have women dying because of botched procedures . . . let's keep the ideology out of this and move forward."

In the days that followed, news reports, editorials, blogs, and radio airwaves hummed with accusations that Mr. Harper’s announcement amounted to “political opportunism” (as said by Stephen Lewis) and that the prime minister only viewed women as “baby-makers” (according to Star blogger Antonio Zerbisias). Others cast Ignatieff’s demands as being entirely about abortion.

Is all this controversy warranted? Not really.

In fact, if you look closely at the two positions, you may be surprised by the amount of common ground. The experts that the prime minister referred to are likely the same ones the leader of the opposition cited: the Guttmacher Institute and the United Nations Population Fund. Their recent research reveals that doubling the investment in family planning, and maternal and newborn health care would radically reduce the number of deaths of women and infants – a 70 per cent reduction in maternal deaths and nearly a 50 per cent reduction in newborn deaths.

Women die during pregnancy or childbirth because they have children when they are too young or too old, or because they have children too close together. Contraception reduces unintended pregnancies and means fewer pregnancy-related deaths and complications. Routine maternal and newborn care – including monitoring during pregnancy, delivery care by trained professionals, care for complications that arise during pregnancy and delivery (including emergency obstetric care and newborn care), and care for complications resulting from unsafe abortions – will save lives. The research estimates that if all women who wanted contraception received it, more than 53 million unintended pregnancies would be averted, there would be 25 million fewer abortions, 150,000 fewer maternal deaths, and 640,000 fewer newborn deaths.

We know what interventions work. We know that behind most abortions, there is an unintended pregnancy. We know that access to contraception will reduce unintended pregnancies. We know that women who deliver babies with skilled assistance in an adequately resourced health facility are much more likely to survive pregnancy and give birth to healthy babies.

And, as Ignatieff acknowledged, there is no evidence that Harper's initiative would specifically exclude abortion. As the opposition leader said, “We just want to lay down a marker that we hope they don't go there.”

The prime minister needs to understand that, if he wants this initiative to succeed, he must take a comprehensive approach to saving women and children’s lives. These are common sense, cost-effective interventions that will result in fewer deaths, improve the educational prospects for children (especially girls), improve and strengthen health systems for the wider community, help stem HIV transmission, and contribute to both gender equality goals and the reduction of poverty.

If the prime minister does not integrate these measures into this G8 initiative, he will have failed all women.