Contraceptive use likely prevents more than 272,000 maternal deaths from childbirth each year, according to a new study led by researchers at the Johns Hopkins Bloomberg School of Public Health. Researchers further estimate that satisfying the global unmet need for contraception could reduce maternal deaths an additional 30 percent. Their findings were published July 10 by The Lancet as part of a series of articles on family planning.
"Promotion of contraceptive use is an effective primary prevention strategy for reducing maternal mortality in developing countries. Our findings reinforce the need to accelerate access to contraception in countries with a low prevalence of contraceptive use where gains in maternal mortality prevention could be greatest," said the study's lead author, Saifuddin Ahmed, MBBS, PhD, associate professor in the Bloomberg School's departments of Population, Family and Reproductive Health, and Biostatistics. "Vaccination prevents child mortality; contraception prevents maternal mortality."
Effective contraception is estimated to avert nearly 230 million unintended births each year. Worldwide, roughly 358,000 women and 3 million newborn babies die each year because of complications related to pregnancy and childbirth. Nearly all of these deaths occur in developing countries, where 10 to 15 percent of pregnancies end in maternal death due to unsafe abortions.
The Johns Hopkins researchers used a counterfactual modeling approach to replicate the World Health Organization's (WHO) maternal mortality estimation method, and to estimate maternal deaths averted by contraceptive use in 172 countries. Data for the analysis were drawn from the WHO database for maternal mortality estimation, survey data for contraceptive use and information on births, female population aged 15 to 49 years and general fertility rates from the United Nations World Population Prospects database, 2010.
According to the authors, worldwide use of contraception averted 272,000 maternal deaths, or 38 deaths per 100,000 women using contraception. The estimate is equivalent to a 44 percent reduction in maternal deaths worldwide. The decline in deaths for individual countries ranged from 7 percent to as high as 61 percent. The study authors further estimated that in the absence of contraceptive use the number of maternal deaths would be 1.8 times higher for the study period.
"Unwanted fertility and unmet contraceptive need are still high in many developing countries, and women are repeatedly exposed to life-threatening pregnancy complications that could be avoided with access to effective contraception. This study demonstrates how use of contraception is a substantial and effective primary prevention strategy for reducing maternal mortality, especially in low-income countries," said Amy Tsui, PhD, senior author of the study and director of the Bloomberg School's Bill and Melinda Gates Institute for Population and Reproductive Health.
"Maternal deaths averted by contraceptive use: an analysis of 172 countries" was written by Saifuddin Ahmed, Qingfeng Li, Li Liu, and Amy O. Tsui.
Funding for the research was provided by grants from the Bill & Melinda Gates Foundation.