Imagine this: Every minute of every day, a woman dies from pregnancy related complications. The Guttmacher Institute states that currently there are about 200 million women in the world who wish to either delay or prevent pregnancy, but do not have access to contraceptives. It is estimated that approximately 530,000 women and girls die worldwide due to complications related to pregnancy, including as many as 70,000 women and girls who die every year from botched abortions.

Even though these statistics are widely used by family planning groups, it is important to remember that these numbers are just estimates. Actual numbers of women dying are much higher when you consider how many deaths go unreported. Child marriage, a common practice across South Asia, is a major but often silent contributor to maternal mortality rates: The risk of dying from complications increases five times for girls under the age of 15 years.

Frustratingly, most people do not even understand the importance of maternal health, or recognize the links between the health of a woman and that of her family, her community, and her country. Children whose mothers are in poor health are less likely to receive education or healthcare. Children who have lost their mothers are more likely to die themselves. Often even these very obvious links between infant mortality and maternal mortality are not made by the average person.

Recently there was huge outrage in Washington over President Obama’s Stimulus Package including $200 million for domestic family planning programs. The provision ended up being taken out of the bill and turned out that it never existed in the first place. But the outrage speaks for itself. Imagine, the worst economic crisis in living memory is unfolding before our very eyes, and American lawmakers did not understand why birth control should be made affordable for low-income women? People need to control the size of their families so they can feed them, and right now people don’t have money. It is a recession. What is so difficult to understand about that? This is what happens when in 2009 men are still making and writing the majority of laws. Yes, even in America, the battle over who controls women’s reproduction continues.

As a Bangladeshi working and living in Washington, a large component of my work is advocacy and lobbying on international family planning. It’s a tricky position to be in and often I find myself in two worlds at once. It just fascinates me how most Americans are unaware of the far reaching effects of the policies created in Washington. So much power, concentrated in one tiny city that is not even a State, but a District and a District that can’t even vote. It makes me think of how much advocacy work is being done here by women’s and family planning groups to once again make the US the leader on global reproductive health after eight years of Bush. US leadership on global health is without a doubt an invaluable and critical asset, but securing women’s access to reproductive health care services goes beyond authoring language in legislation in the fancy marble halls of Congress.

I am sure I have no revolutionary solutions to offer, but I think that dictation on population policies must come from countries like Bangladesh where our maternal mortality ratios rival those of Afghanistan. We should be the authority. Bangladesh is in an excellent position to offer the solutions on population because we are the ones living with the problem at an unimaginable scale.

The Bangladeshi civil society and the non-governmental organization (NGO) sector need to be applauded for their work. I think it is fair to say they have single-handedly taken up the responsibility of prioritizing family planning in the country. Try to imagine where would Bangladesh be today without organizations like the Bangladesh Rural Advancement Committee (BRAC), the Nobel Prize winning Grameen Bank, or the countless NGOs on the ground? Where would we be without the healthcare workers who travel door to door in our villages distributing birth control? Still there needs to be more work done to make the case for maternal health and women’s health.

In Washington, I always hear family planning advocates throw around the word education. It is always education this and education that. I try to make them understand that an illiterate woman in Barisal pregnant with six kids understands that she needs better family planning. She can see she cannot feed her kids and she watches them die. Yes, education is a huge factor but it is not where all our solutions lie.

I think the solution lies within the women’s movement, both in Bangladesh and around the world. I think that this is an issue we must take up and advocate on endlessly and tirelessly until the world gets the point and understands why women’s health should be a global priority. Saving women’s lives is not up for negotiation. The right investments need to be made now in women’s health because we already know what to do and how to do it. We already have the cure. There is no search for a cure like there is for cancer. It is an issue of access. Simple things like increasing the number of skilled birth attendants, increasing their training, making sure clinics are well stocked with the most basic of supplies. It always astounds me that in the “Developed World” if a woman has even the slightest threat of an obstruction in labor, a caesarean section is performed. In countries like Bangladesh, women usually end up with obstetric fistula. Disparities like that should not exist in this day and age. It is needless and it is preventable.

Unless women determine the laws and the policies which will ultimately shape their reproduction, all other women’s rights causes will be lost. Just think if men could get pregnant, how different the world would be. Birth control would probably be available free for all, and abortion would be a birthright.

This year in commemorating Cairo, let us really reflect and uphold the frameworks that were articulated at the ICPD almost two decades ago. It all goes back to what feminists advocated for then and now: Women cannot be empowered until they are in control of their reproduction.

What better time to really win this fight once and for all than on the 15^th anniversary of Cairo? We owe to ourselves. We owe it to women and their families everywhere.
 

Anushay Hossain is the Global Programs Coordinator at the Feminist Majority Foundation. She is a graduate of the University of Virginia and completed her Master’s in Gender and Development from the Institute of Development Studies at the University of Sussex. Ms. Hossain is a native of Bangladesh.