By Dr. Taraneh Shirazian
Most countries around the world do not prioritize women’s health. Maternal mortality, women’s access to reproductive health, and vaccination to prevent cervical cancer are often not considered health care priorities. Even when faced with overwhelming evidence demonstrating that countries that support and advance the health of their women are economically advantaged, many governments do not create or support infrastructure to provide even the most basic health care resources for women. There are engrained beliefs, often tied to the fact that women are undervalued in many societies, that contribute to the alarming number of deaths of women during pregnancy and childbirth each year.
A decade ago I founded Saving Mothers (savingmothers.org), a 501C3 non-profit organization dedicated to developing and implementing low-cost/high-impact programs with the primary goal of reducing maternal mortality. I have been around the world developing programs in global women’s health, traveling to teach and train providers, and deliver clinical services for women in various underserved communities around the world. These experiences have afforded me the unique perspective to see the world of health care and its extreme disparities through the eyes of women who have very little, if any, voice in their own communities.
Working abroad advocating for women and women’s health has made it unmistakably clear to me that the atrocities women face are directly related to the lack of support they receive for healthcare and moreover lack of value placed on their lives. Women with ruptured ectopic pregnancy, bleeding liters into their abdomen, are turned away from hospitals daily because of their inability to pay, and sent home to die. I have seen women labor in their homes for days, without skilled providers or access to transportation, and then arrive at the doorstep of hospitals, half dead, with a dead fetus. If they are lucky enough to survive, the prolonged labor often results in difficult to treat fistulas associated with urinary or fecal incontinence, making them outcasts in their own communities. In many cultures, women are cut, a practice called female genital mutilation (FGM), promoted by both men and women in their communities with the stated goal of ensuring the chastity and marriageability of young girls. This practice often results in difficult and impacted vaginal delivery, putting women at even higher risk of pregnancy related complications, not to mention long term pain and other gynecologic issues. Countries in which women live their lives in this context are often beset with civil unrest or war, further exposing them to become tools of conflict, victimized, terrorized, and mutilated. These women are left with little hope of a better life.
Often societal pressures put women in a position where they must have children to have status, but do so at their own peril. Ironically, in the same places where maternal mortality rates are highest, a woman’s value is correlated to her ability to bear children. Pregnancy in some parts of the world is akin to rolling the dice with up to 1 in 8 risk of dying in pregnancy or childbirth. In parts of the world where women have ready access to obstetric care, pregnancy is not seen in such life or death terms. Imagine becoming pregnant and your first thought is: “I hope I survive.” I have seen and I have operated frantically on these women without any available blood, clearing infection or trying to save what reproductive potential is left because without it, I know they will not have status and place in their communities.
It is through advocating for women worldwide that I have found an empowered voice. Women should not be pawns in the political struggles of governments. They are the cornerstone of every society around the globe, and we should honor them as such. A mother’s death impacts the whole community, leaving the children more likely to die in the first year of life and more likely to be orphaned. When will we understand as a global society that to value a woman’s life is to improve her access to health services and acknowledge her voice to make her own health decisions?
I’ve long felt lucky to be an American trained OBGYN who has both education and rights. I’ve felt lucky that here in the US we have all the resources and technologies to keep women healthy and reduce health risks. But, now I wonder if women are seen exactly the same in the US as they are globally? Are women’s lives valued in the United States? Women’s health and reproductive rights are under siege, and if we don’t exercise voice and advocacy in the United States we will lose the health rights that we have secured over time. It’s time to stop the power of the ruling patriarchy over the bodies of women. It’s time to demand equal health rights for women everywhere. It’s time to demand access to quality reproductive and maternal care. Because every infringement on the health rights of women is about power and control and not about health at all.