Stop Belittling Maternal Deaths

The anti-RH group called Filipinos For Life defended Sen. Tito Sotto’s unfortunate attacks and caustic remarks on the information that an average of 11 maternal deaths occur daily, by claiming that the accurate figure is 4.8 to 8.3. In its statement¹, the anti-RH group cautioned “against the excessive emotional use of the outdated statistic to influence Philippine government policy” and explained their lower figure as follows:

Based on our own estimates, the correct figure is 4.8 maternal deaths a day, based on 2008 data from the National Statistics Office and the National Statistical Coordination Board. This assumes a maternal mortality ratio (MMR) of 99 per 100,000 live births and 1.784 million live births in 2008. Assuming a high MMR of 169 per 100,000 live births, the figure is 8.3.

The group produced a lower figure by using registered live births (1.784 M in 2008) for its calculation. The National Statistics Office (NSO) itself clearly flags the fact that this figure is lower than the actual number of live births due to late and non-registration², and the Filipinos For Life should have heeded the NSO’s caveat.

A concrete indicator of the huge scale of underregistration is the 2007 population census, which counted a total of 2.07 M infants³ (under age 1). Though already a lot higher than the registered births of the following year, the census figure is still lower than the actual number of live births since some 2.5% of infants die before reaching age one⁴ and would not have been counted by the census.

On 7 September 2010, the National Statistical Coordination Board (NSCB)⁵ approved a new maternal mortality ratio (MMR) estimation methodology and the resulting MMR estimates for 1990 and 2000-2010 as “interim estimates for planning and policy/decision-making purposes until such time that the results of population censuses and surveys and updated data from the civil registration system are made available.” The MMR estimate for 2010 is 95 to 163 maternal deaths for every 100,000 live births.⁶

Combining available NSO data on fertility rates and the female population of reproductive age with the new NSCB estimate, the number of maternal deaths in 2010 falls within the range of 2,370 to 4,067 or an average of 6.5 to 11.1 deaths per day (see annex tables for details).

Whether the exact figure is at the lower, central or upper part of the estimate, the important point is to responsibly create policies that would eliminate preventable maternal deaths. Low to high income countries have shown this to be doable. Falsely accusing RH advocates of using outdated data, quibbling about the numbers or callously asking for death certificates as proof will only obstruct the crafting of workable solutions to maternal deaths.

Family planning—whether using natural or artificial methods—can reduce maternal deaths by promoting safer timing of pregnancies or enabling mothers who do not want to get pregnant anymore to fulfill their wishes. A non-pregnant woman has zero risk of complications and maternal death. Skilled birth attendants and emergency obstetric and neonatal care can reduce maternal deaths by providing proper, life-saving interventions to women who do want to get pregnant, or those who get pregnant unintentionally. Humane treatment and counseling for women with post-abortion complications will enable health practitioners to promote and provide natural or artificial family planning so that abortions—which cause a significant proportion of maternal deaths—are minimized if not eliminated. Sexuality education in schools will reduce or delay sexual experimentation among young people, thereby reducing unintended pregnancies and the risk of maternal complications and death.

All of these five measures that can eliminate preventable maternal deaths are in the RH bill. Opponents should be responsible enough to unequivocally point out the parts they can support and the parts they cannot, and engage constructively with the goal of reducing maternal deaths. Belittling maternal deaths contributes nothing and is a grave insult to the millions of mothers who yearly face risks to give new life. ■

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Annex: Estimating the Number of Maternal Deaths

I. Using New NSCB MMR, High Assumption

II. Using New NSCB MMR, Low Assumption

Table Notes:

1. Column D was calculated by dividing Column B with 1,000 and multiplying the result with Column C.
2. Column F was calculated by dividing Column D with 100,000 and multiplying the result with Column E.

Table Sources:     

Column A: National Statistics Office. Projected Populations by Five-Year Age Group and Sex, by Region and Province, and by Five-Calendar Years: 2000-2040 (Medium Series). See http://www.census.gov.ph/data/sectordata/popproj_tab4r.html

Column C: National Statistics Office (NSO) [Philippines], and ICF Macro. 2009. National Demographic and Health Survey 2008. p. 40. Calverton, Maryland: National Statistics Office and ICF Macro. Available at http://www.measuredhs.com/countries/metadata.cfm?surv_id=298&ctry_id=34&SrvyTp=ctry&cn=Philippines

Column E: National Statistical Coordination Board. Interim Estimates of National-Level Maternal Mortality Ratios: 1990 and 2000-2010. Available at http://www.nscb.gov.ph/resolutions/2010/11_10annex2.pdf

Endnotes

1. See http://filipinosforlife.com/2011/08/24/filipinos-for-lifes-official-statement-akbayan%E2%80%99s-tirade-on-sotto-unfair-out-of-context-narrow-minded/ and http://www.titosotto.com/pressroom_headline.php?id=1364
2. From the NSO web page that published the 2008 registered live births: “Statistics presented include only those births which occurred in 2008 and were registered from January 2008 to March 2009. Births that were registered after March 2009 and those that were not registered at all were not included.” See http://www.census.gov.ph/data/pressrelease/2011/pr1153tx.html
3. National Statistics Office. See http://www.census.gov.ph/data/pressrelease/2010/pr10162tx.html.
4. National Statistics Office and ICF Macro. 2009. National Demographic and Health Survey 2008. Calverton, Maryland: National Statistics Office and ICF Macro. p. 96. Available at http://www.measuredhs.com/countries/metadata.cfm?surv_id=298&ctry_id=34&SrvyTp=ctry&cn=Philippines
5. National Statistical Coordination Board. Board Resolution No. 11-10. Available at http://www.nscb.gov.ph/resolutions/2010/11.asp.
6. National Statistical Coordination Board. Interim Estimates of National-Level Maternal Mortality Ratios: 1990 and 2000-2010. Available at http://www.nscb.gov.ph/resolutions/2010/11_10annex2.pdf