Global Moms Bill: An Opening for the Administration to Keep Its Promises?

President Obama and Secretary of State Clinton have voiced concern for women’s safety and health around the world. Legislation introduced this month in the House calls for specific steps to meet that commitment in regard to mothers dying in childbirth.

Earlier this month, California Congresswoman Lois Capps, arguing that “safe motherhood should be a basic right for all women,” introduced the Improvements in Global MOMS Act. “We have a moral obligation to make the right investments to ensure that all women, no matter where they live, have access to basic, life-saving care,” she said.

She is, of course, right. But a more important question is why this legislation—known more formally as the Improvements in Global Maternal and Newborn Health Outcomes While Maximizing Successes Act—had to be introduced at all. As the Findings of the bill explain:

(1) In 2000, the United States joined 188 other countries in supporting 8 United Nations Millennium Development Goals (MDGs), including MDG 5, to reduce the maternal mortality ratio by three-quarters by 2015. In 2005, universal access to reproductive health was added as a target for MDG 5.

(2) On January 15, 2009, United States Permanent Representative to the United Nations Susan Rice stated before the Committee on Foreign Relations of the Senate that President Barack Obama is committed to “making the Millennium Development Goals America’s goals.”

And, yet, Millennium Development Goal 5 is the furthest from being met of all the goals. Given the current lack of progress, observers don’t expect it will be met until 2076 in Asia and later in Africa (as noted in the bill)—in other words, not in our lifetimes.

Capp’s legislation goes on to note that 8.8 million children under the age of five die each year—more than 24,000 every day—and more than 3.5 million of those children die in the first month of life. Between 350,000 and half a million women died in childbirth each year between 1980 and 2008, mostly from preventable causes, and another 10 million suffered serious medical complications from childbirth and pregnancy.

A study by the Bill and Melinda Gates Foundation, published in The Lancet this year, found some progress in reducing maternal mortality: they found that the rate had declined from 529,000 per year in 1980 to about 350,000 in 2008. However, half of the women who died of complications from pregnancy or childbirth were located in only six countries: India, Nigeria, Pakistan, Afghanistan, Ethiopia, and the Democratic Republic of the Congo. Worse yet, nearly 100,000 more women died than would otherwise have died in the absence of AIDS or effective treatments for it.

The World Health Organization says that 70 percent of maternal deaths come from only five causes: hemorrhage (25%), infection (15%), unsafe abortion (13%), eclampsia (12%), and obstructed labor (8%). All five can be prevented with access to care ranging from family planning services (including safe access to abortion), skilled prenatal and childbirth care; and follow-up services. Activists who work to eliminate the practice of female genital cutting and doctors who treat patients who have been cut all say that the often widespread practice is a large contributing factor to maternal and child mortality. Women who undergo FGC are twice as likely to die in childbirth and more likely to have stillborn children. In addition, treatable diseases like malaria, anemia and HIV can complicate pregnancies, especially when left untreated, and contribute to about 20 percent of maternal mortality in the Global South.

Capps’ legislation directs the Obama Administration to identify 30 countries that should be considered priorities—because of the number of child deaths, the rate of maternal mortality, the malnourishment rate among women of child-bearing age and the lack of current access to family planning programs—and report to Congress what programs exist to combat those problems, where the United States can assist and what programs we can undertake or contribute to for the best results for the most people. The kinds of assistance authorized under the legislation are as broad as the immediate and long-range causes of maternal and infant mortality. Starting with comprehensive sex education programs, the bill ties the causes of maternal mortality to the role of women in society, the access to family planning services and knowledge, the health of women before they get pregnant, prenatal care, medical supervision during and after pregnancy, breast feeding, immunizations, environmental toxins, antibiotic resistance, capacity-building in the health care sector, orphan care, FGC and water quality. If it sounds like everything but the kitchen sink, that’s because doctors and researchers increasingly recognize that pregnancy outcomes, even in the United States, have as much to do with what a woman does and is subjected to before pregnancy as during the time that she is pregnant.

But for many women’s rights advocates, the dawn of the Obama Administration and, in particular, the elevation of Hillary Clinton to secretary of state were supposed to mean more than the status quo for the women and girls of the world. After all, during Hillary Clinton’s confirmation hearings, she promised as much:

“I want to pledge to you that as secretary of state I view these issues as central to our foreign policy, not as adjunct or auxiliary or in any way lesser than all of the other issues that we have to confront.”

And although the Obama Administration reversed the global gag rule on family planning organizations and Clinton appointed Melanne Verveer to be the first ambassador-at-large for global women’s issues, action on global women’s issues hasn’t lived up to the promises made at the beginning of the administration. Apart from a brief mention in Obama’s vaunted Cairo speech that many women’s advocates felt fell far short of a call for change and the announcement of a $17 million commitment to help fight rape in the Congo—even as the rape rate committed by civilians was skyrocketing without any respite for women from rapes by soldiers and militiamen—the Administration has been rather quiet about its promise to make issues of importance to the world’s women an integral part of its foreign policy.

In that light, the Capps bill, whether as a marker to the Obama Administration that Congress hasn’t forgotten its promises or as a precursor bill to an eventual amendment that does, indeed, force the government to spend more of its foreign policy dollars on the health of the world’s women and their children, does seem like a necessary first step. The administration needs to honor its commitments, both to the women of the world and the women of America who voted for Obama.