Guest blog by Dr. Jennifer Hirshfeld-Cytron, Reproductive Endocrinology and Infertility Fellow, Department of Obstetrics and Gynecology, Northwestern Memorial Hospital

The Obstetrics and Gynecology Grand Rounds this morning was given by past FIGO (International Federation of Gynecology and Obstetrics) and previous chairman of the department, Dr. John Sciarra.  He provided an incredibly informative and moving description of the global issues affecting women, particularly in the developing world.  He highlighted the issues of maternal mortality, maternal morbidity, STDs, cervical cancer, and education inequality.

For instance, in Afghanistan, 1 in 6 women will DIE from pregnancy related complications compared to 1 in 4100 in the developed world.  Pregnancy related complications include: abortion related deaths, hemorrhage, thrombotic events and eclampsia (see below). 20.5 million unsafe abortions occur each year worldwide and account for 60,-80,000 deaths.

Furthermore, HIV/AIDS accounts for 11% of worldwide deaths with approximately 47 percent of the 34.3 million adults living with HIV/AIDS being women. Cervical cancer, a preventable cancer with appropriate screening, sex education and potentially the vaccine, affects 200,000 women worldwide and is second only to breast cancer in incidence.  Cervical cancer screening in the developed world centers on cytology, which is not available in the developing world. He further highlighted the inequities of women.   Worldwide women work 66% more than men but receive only 15% of the income.  Illiteracy in parts of the developing worth is greater than 65% for women. This just begins to highlight the complicated issue of providing appropriate family planning education to the developing world.

These staggering and incredibly disturbing statistics leave us with only one question; how can we raise the status of women worldwide? Efforts are being done to partner developed with developing world medical schools to increase technical skills for the care of women, such as safe abortions.  A website (www.glowm.com) has been started by Dr. Sciarra and others providing education in the form of book chapters and how-to videos to begin to enhance knowledge to the developing world.  Access is huge problem for women and foundations such as the Bill and Melinda Gates Foundation are working towards these and other efforts.  In short, get involved.

As Mahmoud Fathalla, past president of the International Federation of Gynecology and Obstetrics, said: "Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving."

Comments

Education is the answer. Once a woman or anyone for that matter receives an education, they then have the tool to help themselves and their community.

quality between women and men is a fundamental right, a common value of the EU, and a necessary condition for the achievement of the EU objectives of growth, employment and social cohesion. Although inequalities still exist, the EU has made significant progress over the last decades in achieving equality between women and men. This is mainly thanks to equal treatment legislation, gender mainstreaming and specific measures for the advancement of women.

“Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.” Sometimes humans does not seem too human at all. I have seen it everywhere, but the most touched i felt after visiting India. Human life in many areas there is not worth much at all. Sad, but true...

Oh my goodness, I didnt realise any of that was so prominent - that's an alarming amount of statistic, governments need to invest more in healthcare, its not fair that people suffer just because of their location in the world for something which could be treated in another.

Sadly I feel you brought up some real great points and ideas quality between women and men is a fundamental right. This is so sensitive and its one thing my country has been trying to fight for women. Women are experiencing so many problems

Recently, I read that even though life expectancy is higher for women than men in most countries, a number of health and social factors combine to create a lower quality of life for them. Unequal access to information, care and basic health practices further increases the health risks for women. Women need to be educated about these issues and have easier access to information such as this blog.

I can't believe it. Those statistics are very sad and shocking. Living in our country you just don't think things like this are going on somewhere else in the world. I will have to look into the Bill and Melinda Gates Foundation if they are truly helping these people. Thanks for bring this to our attention.

Having spent a great deal of time in the third world, I would like to observe that much of a young girl's education surrounds marriage, sex and contributing to the family unit. In Basutoland in the 1960s girls were initiated in cold mountain huts how to dance, how to sit when a man approaches and what to cook. W need to pluck the brightest out of this traditional environment and educate them here, or in Europe so they can go back to their homeland and make a contribution. The old ways die hard and only a eye-opener will make significant change. Thank you for the opportunity to comment

The graphical representation is really easy to digest and was able to hint to us the underlying problems of the poorer health of women. It is indeed sad for us to learn of such inequalities in the developing world, but the problem is not that clear cut. The idea that the female is inferior to the male is widely accepted in the developing world, by not only men, but also some women. The same scenario is observed in Asian countries, such as Japan, where females with the same qualifications as their male counterparts will almost always have a lower upward mobility. Perhaps, we should gather the opinions of the women to see if they are willing to accept equality in the first place.

With out reducing poverty and increasing girls education, efforts to reduce woman mortality rate will be very hard indeed.

Yes, i agree with that women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving. I must add up that the society fails to see what our women needs and i'm afraid that its been like that for all these years.

It is sad to know the statistics that women are not treated equally and enjoy their human rights for themselves and for their children. A reality to all to address especially to the societies who put womens rights at the back end.

This is a very sad yet very useful blog. Thank you for posting such informative post, this can help spread awareness to our societies women and also in men.

This is a very important data: «Furthermore, HIV/AIDS accounts for 11% of worldwide deaths with approximately 47 percent of the 34.3 million adults living with HIV/AIDS being women». Women who transmit AIDS to their children. A cure for AIDS is a priority.

1 in 6 women dying from pregnancy related complications is an appalling statistic. I am completely floored. I suppose I am guilty of developed world complacency or if you like ignorance. I had no idea that this statistic would be like this. In this day and age this stat regardless of where you live and what you believe should not be the norm.

I can't believe there are 60-80,000 deaths per year from unsafe abortions. Pro choice is the only way to go. Thanks for the article.

Fascinating statistics. I think another reason for women having pregnancy complications at birth in non-developed countries is because of the hygiene consideration. We are very fortunate to always ensure that tools are sterilized before use. Thank you for sharing.

This is very alarming figure. I agree with Mahmoud Fathalla when he said "Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.” I think we need to increase information,education and awareness about women's health.

Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.And I am agree with this saying....

Mahmoud Fathalla has hit the nail on the head with his very perceptive comment. It is restrictive practices carried on in the name of religion and/or culture that keep many areas of the world in the dark ages, even in the so-called modern societies of today. It is only social awareness at the grass roots level that can cure this, not just technical knowledge in the hands of a few.

“Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.” Thank God this has changed a lot for better even in rural part of India.

Unbelievable, women are still getting abused all around, and it is not happening in undeveloped countries only, even in the U.S and Europe you see women getting domestic abuses, abuses at work and making them pass for the shame of telling the story over and over and get questioned as if it would be their fault.

13% for unsafe abortion? It's ridiculous, there are so many types of contraception around us. Lack of info is the real problem.

My sister went to Africa to visit her missionary daughter. What she witnessed and learned about women and how they are treated was shocking to her. How can we raise the status of women worldwide? That is the question she had just for the village she visited in Africa. They didn't know or want to know about birth control, abortion, or how to prevent aids. In fact, it is customary for the men to carry on with as many women as possible, thus spreading HIV virus. So keep up the good work Dr, Sciarra. Thomas

What an informative article, really enjoyed the extensive details. Thanks for such a wonderful contribution. The stats were astonishing.

The Global Alliance for Women's Health (GAWH) is committed to advancing women's health in all stages of life and at all policy levels through health promotion, education, advocacy, and program implementation.

"women are dying because societies have yet to make the decision that their lives are worth saving.” These words say it all. A very remarkable post thankyou for highlighting how devalued women really are in this world

This is a very interesting article, I was caught before eclampsia set in but I do feel that women should be monitored much more closely after they reach 30 weeks of pregnancy, as your article shows there are many ways that problems occur we need to get better at recognising those signs before they develop. More education for women on risks and signs to look out for would be good I felt that I wasn't equipped to recognise problems and to know what was normal or not!

I have to say for some reason the one that got me is 13% dying due to unsafe abortions....That means many more are forced into having children who they id not want in the first place..... I wonder how many of those kids end up involved in criminal activities later on in life... Vicious circle... I'm now going to go check the stat for 2011... here hoping a lot has changed since 2005

I can't believe that in 2011 one in six women will die from pregnancy related complications in some countries. I understand that in Africa it might be even worse. Thank you for this eye opening, informative article.

As we know that whenever something new happens or discovered, there are so many problems. Especially for women. But what you are looking to do is change cultures! Our efforts are valorous but we face a very steep mountain to climb.

There is no doubt that in the "developing world" problems exist. Especially for women. But what you are looking to do is change cultures! I admit, to see suffering and death that could be avoided borders on heartbreaking. Your efforts are valiant but you indeed face a very steep mountain to climb. Just my opinion Sara

This is simply unbelievable. These women should not be dying like this. People need to wake up and the govenment needs to take not of just what is going on. It's not acceptable in this day and age.I'm furious.

Here in the states we take for granted what so many others lack in the developing countries. The more education that can be provided and the more resources that can be offered to these parts of the world, the better.

Thanks for the very informative read. It appears the HPV infection is going to result in many other problems besides cervical cancers. Research shows that many of the oral and throat cancers are now related to the HPV virus. Its great that a vaccine has been developed for women and given to pre-teen girls for the prevention of this virus. It would be equally great if the same vaccine were as effective for the male population as they are also being affected. EDITOR's REPLY: they are testing the vaccine in boys.

I just found your blog while searching for articles about pregnancy related death. Very informative post. Thank you for sharing this with us.

The governing bodies of these countries need to be targeted to increase the awareness of their people; they always have money available for arms and weapons - they need to make money available to look after the wellbeing of their own people.

This is a really excellent read for me. Must admit that you are one of the best blogger I ever saw. Thanks for posting this informative article.

This is an impressive figure, developed countries should do more to prevent and avoid health issues that can be improved, as is abortion, there are multiple solutions, but there is no commitment, countries such as Cuba with less economic development, provide more than 50000 doctors each year to support poor countries, is a worthy example to copy, despite its political and social situation, we must recognize that

I feel you brought up some real great points and ideas and i know that you mentioned the Bill & Melinda Gates Foundation i wanted to say afew words about it that its Guided by the belief that every life has equal value, the Bill & Melinda Gates Foundation works to help all people lead healthy, productive lives. In developing countries, we focus on improving people’s health and giving them the chance to lift themselves out of hunger and extreme poverty. In the United States, we seek to ensure that all people—especially those with the fewest resources—have access to the opportunities they need to succeed in school and life

I am blown away that in this day and age women still die from pregnancy problems. We spend billions on war while this is still a problem..... Food for thoughts

A current concerned issue. Thanks very much for sharing a lot of this good information! Looking forward to reading more blogs!

I really liked your post.Will come back for future updates..

quality between women and men is a fundamental right, a common value of the EU, and a necessary condition for the achievement of the EU objectives of growth, employment and social cohesion. Although inequalities still exist, the EU has made significant progress over the last decades in achieving equality between women and men. This is mainly thanks to equal treatment legislation, gender mainstreaming and specific measures for the advancement of women.

Unfortunately, the political climate needs a lot of shaking out in some poorer countries. Note what is currently happening in northern Africa right now. Women's rights overall will hopefully get a long overdue boost up. GD.

Although I agree with most of the article, I do believe that simple education could go a long way to finding and preventing things from happening. There needs to be more support.

i agree with Lonny Lang Women should all be pro-choice. It is their body, after all.

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