Childbirth a matter of life and death for Yemen’s women and girls
Women and girls of childbearing age (15 to 49 years) are among the most acutely vulnerable in Yemen’s conflict. An estimated 5 million women and girls of childbearing age, and 1.7 million pregnant and breastfeeding women, have limited or no access to reproductive health services, including antenatal care, safe delivery, post-natal care, family planning, and emergency obstetric and newborn care. Over 1 million pregnant and breastfeeding women are acutely malnourished and risk giving birth to newborns with severely stunted growth due to rising food insecurity.
One woman dies every two hours during childbirth from almost entirely preventable causes. The UN estimated that the maternal mortality ratio in Yemen in 2017 was 164 maternal deaths per 100,000 live births. This is about five times the average in the Middle East and North Africa region. The key drivers of the high maternal mortality ratio in Yemen are poor access and utilization of lifesaving reproductive health services.
Health facilities have inadequate qualified health care workers, particularly those needed to provide emergency obstetric care. Obstetric gynecologists, anesthetists and midwives are particularly scarce, affecting access to lifesaving caesarean operations when needed. Between 5 to 10 per cent of all pregnancies need a caesarean intervention to save the lives of the mother and/ or the newborn baby. The quality of care has continued to deteriorate due to underinvestment in health care. Referral systems are not functional in most districts. Hence, women end up dying before reaching a hospital.
Moreover, women of reproductive age, including pregnant women, are facing challenges in accessing the reproductive health supplies and services they need due to the chronic shortage of medicines and supplies at health facilities. Medical equipment is either lacking or in a poor state as proper maintenance regimes have not been followed. Whenever there are stock-outs of medicines at health facilities, patients would be asked to buy medicines from private pharmacies. Yet, given widespread poverty caused by the protracted crisis, many are faced with the choice between buying prescribed medicines or buying food or other basic needs from the little resources they have.
Without access to lifesaving reproductive and maternal health medicines, approximately one million women estimated to deliver annually are particularly at risk. Another estimated one million women who would want to use family planning to postpone pregnancy during this crisis period would be at risk of unwanted pregnancies and consequent risks to their lives and their newborns.
As the conflict continues, maternal deaths in Yemen will increase as women and girls of childbearing age struggle to access the reproductive health services they desperately need. Funding for reproductive health, which remains severely underfunded, remains urgent not only to sustain but to scale up reproductive health services.