The United Nations seeks to decrease maternal mortality ratios (MMR: maternal mortality during pregnancy or within 42 days of pregnancy’s termination) by 75% from 1990—2015. Research on maternal mortality between 1980—2008 in 181 countries found maternal mortality is declining but remains too high. Maternal deaths declined from 526,300 in 1990 to 342,900 in 2008. Overall, MMR declined from 420 maternal deaths per 100,000 live births in 1980, to 320 in 1990, to 251 in 2008. The U.S. ratio has risen from 12 in 1980, to 17 in 2009. The 21 countries with the highest MMR account for almost 80% (79.4%) of all maternal deaths globally; the top 6 countries (India, Nigeria, Pakistan, Afghanistan, Ethiopia, Democratic Republic of Congo) account for 50% of all maternal deaths. Programs to reduce fertility or improve an individual woman’s life, maternal education, and access to skilled birth attendants have the greatest impact on maternal mortality. HIV/AIDS has the worst effect; without HIV, there would have been 281,500 maternal deaths in 2008.
The Lancet, May 2010
First, lower cholesterol, now lower risk of stroke—once again, walking is proved to be a simple, beneficial, way to increase women’s health. Research explored data from 39,315 participants in the Women’s Health Study (WHS), which was designed to explore use of low-dose aspirin and vitamin E to prevent cardiovascular disease and cancer. Compared to women who didn’t walk, women who walked two or more hours weekly had a 30% lower risk of having a stroke, and a 57% lower risk of hemorrhagic stroke (bleeding within the brain and between the inner and outer layers of the tissue covering the brain). Women with a brisk walking pace had a 37% lower risk than women who didn’t walk; women whose walking pace exceeded 4.8 km/hour had a 68% lower risk than women who didn’t walk. Evidence suggests a 25-30% reduction in stroke risk from physical activity.
Stroke, June 2010
The Agency for Healthcare Research and Quality (AHRQ) has concluded what NWHN already knew: vaginal birth after cesarean section (VBAC) is a safe, reasonable choice for most women. Since 1996, VBAC rates have declined sharply due to misguided hospital policies restricting it and opposition from groups like the American College of Obstetricians and Gynecologists. 90% of pregnant women who had one cesarean will have a repeat cesarean. AHRQ analyzed 203 studies of healthy U.S. women of reproductive age with a prior cesarean. Women were eligible to go through labor and try to have a vaginal birth or to have another cesarean section. 74% of women who chose labor delivered vaginally. There was a higher risk of maternal mortality among women who chose a repeat cesarean (9.6 maternal deaths per 100,000 live births) compared to women delivering vaginally (1.9 maternal deaths). Among women with high-risk conditions who chose a repeat cesarean delivery, rates of neonatal mortality were also higher. Clearly, VBAC is safer for women and their babies.
Agency for Healthcare Research and Quality, March 2010