It’s High Time We Sent High-tech On Hiatus: Family Planning, a practical low-tech intervention for maternal health

Maternal Mortality is a huge international health issue, and yet, amazingly, there has been a serious lack of attention and re-evaluation of interventions by health policy makers, governments, and healthcare professionals themselves. As Allan Rosenfeld and Deborah Maine published in Lancet (circa 1985), “instead of drawing attention to the problem and lobbying for major programmes and changes in priorities most obstetricians concentrate on subspecialties that put emphasis on high technology.”[i] In this tech crazed generation, much of the international healthcare interventions have focused on technological advancements, while disparities between the developed and developing world continue to pose challenges to reducing maternal mortality that technology alone cannot resolve. During the last 25 years, some high to middle-income countries have managed to reduce their maternal mortality, however, few of these began with the same extremely high rates that are now estimated for the poorest countries.[ii] We need to break this pattern of prioritizing high-tech solutions before it plagues maternal healthcare any longer. Low-tech alternatives, such as family planning and contraception, should be re-evaluated and improved upon. Maternal Mortality could be reduced greatly by increasing education and access to the most basic family planning methods.

Family planning and contraception are far from new ideas, however, 250 million women worldwide still lack the support of their country’s health policies, their communities, or even their families to access family planning and contraception. This fact further increases these young women’s risk of suffering from poor maternal health.[iii] Targeting family planning interventions to reach the most vulnerable poor, rural women is essential if maternal mortality is to be reduced 75% by 2015 as a part of the UN’s Millennium Development Goals.[iv] The developed world puts so much emphasis on keeping urban centers of society up-to-date with the highest-trained professionals and the most modern technology, while the developing world struggles to emulate this healthcare model and subsequently fails. One in six women in the developing world is at a risk of dying as a result of pregnancy-related complications compared with around one in 30,000 women in Northern Europe.[v] Annually an estimated 529,000 maternal deaths occur.[vi] The majority of these deaths are women in rural areas of the developing world who face logistical, financial and cultural barriers to accessing high quality healthcare facilities, supplies, and skilled birth attendants. But however difficult it is to overcome these barriers, especially existing societal norms and expectations for women to marry young and to have large families, family planning is an invaluable service, which enables women to make the best choices for their family size, timing, and sequencing.

One additional benefit of focusing on reproductive education over modern advancements in technology is that family planning is essential in reducing maternal mortality because it increases a woman’s ability to avoid unintended and often even dangerous pregnancies, especially in the case of young, underdeveloped mothers. Special attention should be given to reproductive education and family planning for adolescent females.[vii] Although only around 11% of all births worldwide are in adolescents aged 10-19 years, they attribute to the overall burden of disease by 23%.[viii]  14% of all unsafe abortions in low and middle-income countries are among women ages 15-19 and an estimated 2.5 million adolescent females have unsafe abortions every year.[ix] Many of these procedures leave young girls with long-term injuries and many more health problems are closely associated with negative outcomes of pregnancy during adolescence. Throughout the world, young women need comprehensive sex and reproductive education, as well as accessibility to a full range of family planning services, including access to appropriate contraception and alternative interventions for the prevention and treatment of sexually transmitted infections (STIs). Support for young mothers must come from all levels, starting with government and active health policies and trickling down to communities and families.

In summary, high-tech ideals need to make way for strong low-tech solutions for maternal healthcare. Maternal Mortality could be reduced greatly by increasing and improving education and access to the most basic family planning methods.

{by Morgan Hume}

[i] Rosenfeld, A, Maine, D. “Maternal Mortality A Neglected Tragedy. Where in the M in MCH?” Lancet. 13 July 1985.

[ii] Ronsmans, C, Graham, W.J. “Maternal mortality: who, when, where, and why.” Lancet. 368:1189-1200. 2006.

[iii] Guttmacher Institute. Facts on Investing in Family Planning and Maternal and Newborn Health. November 2010. Web. 26 Nov 2011.

[iv] “Goal 5: Improve Maternal Health.” Millennium Development Goals Report. United Nations, 15 Jun 2010. We Can End Poverty 2015 Millennium Development Goals: A Gateway to the UN System’s work on MDGs.

[v] Ronsmans, C, Graham, W.J. “Maternal mortality: who, when, where, and why.” Lancet. 368:1189-1200. 2006.

[vi] Ibid.

[vii] World Health Organization. “Adolescent Pregnancy Fact Sheet.” Department of Making Pregnancy Safer. WHO. 2008. Web. Accessed 4 Dec 2011.

[viii] Ibid.

[ix] Ibid.


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