MDG 5, HUMAN RIGHTS, AND MATERNAL HEALTH IN AFRICA
into maternal health strategy in affected countries: discouraging early
marriage/pregnancy, eradicating harmful traditional practices such as
female genital cutting, and ensuring timely access to obstetric care. 66
C. Obstructed Labor and Unsafe Abortion
The third and fourth major contributors to maternal deaths in Africa are
obstructed labor and unsafe abortion. Obstructed labor arises from
disproportionality between the pelvis of the mother and the fetal head or
from the malposition or malpresentation of the fetus during labor. 67 In
absence of timely intervention, obstructed labor can have disastrous
consequences for both mother and child. The child may be stillborn, suffer
asphyxia and brain damage, or die shortly after birth whereas the mother
may suffer obstetric fistulae. 68 Complications associated with obstructed
labor accounts for eight percent of global maternal deaths. 69 Most of these
complications are largely preventable by regular attendance at antenatal
clinics and engaging the services of SHP during delivery services, which, as
will be shown shortly, are in short supply in many countries in the region.
Unsafe abortion, on the other hand, is defined as “a procedure for
terminating an unwanted pregnancy either by persons lacking the necessary
skills or in an environment lacking minimal medical standards or both.” 70
Although it has always been assumed that the number of deaths resulting
from abortion in Africa is the highest globally, this is not borne out by
available evidence. In fact, abortion-related mortalities in the region are the
least of anywhere in the world. 71 Unsafe abortion accounts for 3. 9 percent
of all maternal mortalities in the region, compared to 8. 2 percent in
developed countries, 5. 7 percent in Asia, and twelve percent in Latin
America and the Caribbean. 72 Deaths resulting from unsafe abortion in
Africa are considered in some quarters to be byproducts of restrictive anti-abortion laws in many countries in the region. 73 The most restrictive of
these laws are those that “either permit abortion only to save a woman’s life
66. WHO, 10 FACTS ON OBSTETRIC FISTULA (March 2010), http://www.who.int/features/
67. WORLD HEALTH REPORT 2005, supra note 10, at 64.
69. Id. at 62.
70. WHO, PREVENTING UNSAFE ABORTION (2010), http://www.who.int/reproductive
health/topics/ unsafe_abortion/hrpwork/en/ index.html.
71. Khan et al., supra note 42.
73. But see Lisa B. Haddad & Nawal M. Nour, Unsafe Abortion: Unnecessary Maternal
Mortality, 2 REV. IN OBSTET. & GYNEC. 122, 124 (2009).