Health risks for both women and infants accompany pregnancy

Pregnancy is a risky time for women and infants, especially when pregnancies come close together and when women and infants do not receive adequate medical care and advice.¹ In the Philippines, an estimated 200 women die from pregnancy-related causes (such as infection, obstructed labor, severe bleeding, hypertensive disorders and other complications of births, abortions or miscarriages) for every 100,000 live births.⁵ In 2008, births and miscarriages resulted in about 3,700 women’s deaths. Some 1,600 of these women had not wanted to become pregnant. Because abortion is illegal in the Philippines, the procedure is almost always clandestine and often unsafe.⁶ Projections based on data from 2000 indicate that about 1,000 women in the Philippines died as a result of abortion in 2008; as many as 90,000 were hospitalized for complications.

Pregnancy-related deaths and hospitalizations keep women out of the workforce and away from their families, and have countless other effects on women’s and society’s well-being. The DALY (disability-adjusted life year) is an internationally used measure of the years of productive life lost to death and disability from disease and other health conditions. In 2008, Filipino women lost an estimated 311,000 productive years of their lives due to conditions related to pregnancy and birth—167,000 DALYs were due to intended pregnancies and 144,000 were related to unintended pregnancies. This loss of productive years of life is greater than the annual loss among Filipino men and women from traffic accidents or diabetes.⁷

Birth also entails health risks for the infant. In 2008, an estimated 52,000 babies in the Philippines (22 out of every 1,000 born alive) died before their first birthday; 30,000 of them died within a month of being born. Spacing births helps babies survive: Those born at least two years after a previous birth have the best chance of survival.² However, 33% of births to Filipino women who already have at least one child occur less than two years after a prior birth.⁸

Newborns suffering from conditions such as birth asphyxia and trauma, premature birth, low birth weight and infections accounted for one million DALYs in 2008. This loss of productive years of life among Filipino children accounts for nearly twice the DALYs related to tuberculosis, more than twice those due to diarrhea and triple those due to measles, pertussis and tetanus combined.⁷

Poor women face a host of obstacles to having healthy pregnancies and births. The poorer women are, the less likely they are to have prenatal care, give birth in a health facility or have a skilled attendant at delivery—factors that lower the risk for maternal death.^1,2 Poor women also tend to have shorter intervals between births compared with better-off women.² The consequences can be dire for their babies: The death rate among infants whose mothers received no prenatal or delivery care is 3.6 times the rate among infants whose mothers did receive such care.² Meanwhile, women in the poorest fifth of the Philippines population have nearly three times as many births as those in the wealthiest fifth (Figure 1).^2,8