For too many, still no room at the inn

"Women are not dying because of disease we cannot treat; they are dying because societies have yet to make the decision that their lives are worth saving."

— Dr. Mahmoud Fathalla, author of the "World Report on Women's Health"

A young woman, large with child, took a long journey with her husband; during the trip she went into labor and delivered her baby in a barn. There was no room at the inn, nowhere else for her to go. After delivery, she made a bed for the baby out of a feeding trough.

That's the story of the "first Christmas" a story most of us know, regardless of our heritage or beliefs. Today, more than 2,000 years later, this story makes me wonder: Why is there still no room at the inn for women like Mary? Why are millions of women still giving birth in stables, on dirt floors and in unspeakable conditions, without access to trained birthing attendants?

The poor conditions for expectant mothers around the world represent one of the greatest inequities of the 21st century. In the time it took to write this article, many women (three every five minutes) in the poorest countries of the world have died from preventable complications of pregnancy and childbirth. Almost 1,000 women will die today.

I can't bear the thought that one of these could have been my wife, my mother, my sister, when something could have been done.

As a father in Maryland, I am fortunate that my wife had access to the great medical care she needed before, during and after the birth of our two children. This was particularly important because she suffered serious complications following an emergency cesarean section with our first son. We were grateful for our fortunate circumstances, and for the high level of training and available medicines to manage the situation. In different conditions, my wife could have easily become a statistic of maternal mortality.

The good news is that most such deaths — usually from severe bleeding or infection — can be prevented by 1) improving access to skilled care and essential medicines and supplies during pregnancy and delivery; 2) ensuring timely access to emergency obstetrics and newborn care; and 3) providing family planning services that enable women to space pregnancies to support optimal health for mother, baby and family.

In the developing world — in places like Haiti or South Sudan, where my organization, IMA World Health, works — even basic childbirth supplies like sterile gauze or a bar of soap are virtually unobtainable for many expectant women. While my wife and I pondered options for prenatal vitamins, providers and pain-management methods, millions of women will not have the basic option of seeing a trained medical professional.

During a recent trip to Haiti, my staff at IMA and I met a woman name Brigitte who faced an impossible choice: She could feed her family that month, or she could buy the basic supplies needed to deliver her baby. (Many Haitian hospitals lack the resources to provide medical supplies to patients, who must provide their own.) These basic supplies would cost her about $35 — the equivalent of her family's entire monthly income.

Fortunately, through one of IMA's programs, Brigitte received a Safe Motherhood Kit containing clean and sterile birthing supplies to prevent infection; education on safe birthing practices; and a layette to keep the newborn warm during those first critical hours. This simple $25 kit contributes to safe deliveries for women with an uncomplicated delivery. Thanks to a kind donor, Brigitte's chances of infection and death decreased drastically, and we later learned that she safely delivered a healthy baby boy.

Maternal death is morally unacceptable. I believe it's up to each of us to stand up for the human rights of women and call for government leadership to continue support for maternal mortality reduction and global improvements for women's health. This, however is not just a problem for governments to tackle; as individuals, we can speak out for women and support local, national and international organizations that are working every day to reduce unnecessary death and suffering.

All lives have equal value no matter where they are born and no matter where they currently live.

Richard L. Santos, a Silver Spring resident, is president and CEO of IMA World Health, a nonprofit based in New Windsor providing health care services and supplies to vulnerable and marginalized people. He can be reached at

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