On Monday, June 17, ACNM Vice President for Global Outreach Suzanne Stalls, CNM, spoke at a congressional briefing sponsored by ACNM, AMREF USAI, AWHONN, Frontline Health Workers Coalition, IntraHealth International, Jhpiego, and White Ribbon Alliance for Safe Motherhood. Below is an excerpt of her comments. Her full text comments are available here.

I am pleased that we are here today to discuss the challenges that face women’s health access around the world and here in the United States. The annual rate of maternal deaths today is equivalent to 939 Boeing 777s crashing every year, or 2 to 3 of these jets crashing per day. The lifetime risk of dying in pregnancy and birth is 1 in 8 in Afghanistan and Sierra Leone; in Ireland it is 1 in 48,000. Can you imagine any other public health scenario where so many deaths occur and such huge disparities exist without an enormous public outcry?

One might think that these bleak numbers and circumstances apply only to the developing world. While 99% of the maternal deaths occur in the developing world, the situation in the United States is alarming. We spend more than $111 billion annually on care related to childbirth, spending twice as much as France, and yet we rank 31st in Save the Children’s 2011 Mother’s Index. The top 5 countries in this index are Norway, Australia, Iceland, Sweden, and Denmark. All of these countries have midwifery as the front line model of care for women.

Women in the US now have a higher risk of dying from pregnancy and birth related complications than in 45 other countries. Our maternal mortality ratio has doubled since 1987. With the 47% decline in maternal mortality around the world, we are one of only 26 countries where the problem is worsening.

Given this disturbing snapshot of both the world and here at home, where do we go from here and what can we do?

There is a shortage of midwives and obstetrical providers throughout the world. It is estimated that by 2015, with enough skilled and competent midwives supported by a functional health care system, more than two thirds of the maternal and newborn deaths could be averted. To ensure access and adequate supply of providers, it is essential that the federal government continue to invest in the growth of midwifery education programs and midwifery students. ACNM appreciates the investments Congress makes each year and urges continued support for midwifery education through Title VIII of the Public Health Services Act.

Currently there are 2 major bills that members of Congress can support or co-sponsor to improve the health of moms and babies:

· The MOMS 21 (HR 2286) Act, sponsored by Rep. Lucille Roybal-Allard will ensure greater national focus on improving maternity care. Part of this bill would enable designation of a maternity care shortage so that critical workforce issues can be identified and addressed and measures instituted to foster growth in the professions of obstetrics/gynecology and midwifery.

· The Quality Care for Moms and Babies Act (S. #425/HR #896 introduced by Senators Stabenow and Grassley and Rep. Eliot Engel) will provide funding for inter-professional collaboratives to improve care and updating quality measures used by Medicaid. In addition, this bill would direct the Agency for Healthcare Research and Quality (AHRQ) to develop surveys to measure the care experience of childbearing women and newborns.

My children often ask me when I am going to retire. I tell them that I can only rest easy when I know that there is no longer a woman in a remote village in South Sudan who is bleeding to death by the side of a road for lack of a medication that costs several dollars, or a woman who dies from eclampsia in Pakistan because of the gender inequity which prohibits her from leaving her house to seek the care she needs.

My grandfather, a small town physician, watched his wife die from a pregnancy-related complication that could easily have been treated today. His hair turned white in 6 months; my grandmother left behind 3 small motherless children who have felt her loss their whole lives. I would ask you to join with us in working to end such a senseless tragedy.