Melinda French Gates says she takes personally the deaths of hundreds of thousands of women and babies during child birth each year and believes more people should get involved in the fight for improving maternal health care.
French Gates, the Bill & Melinda Gates Foundation co-founder and co-chair told The Associated Press that when her daughter, Jennifer, gave birth to Leila — Jennifer's first child and the Gateses' first grandchild — earlier this year, she couldn't help but think of her own experience giving birth.
“That’s a terrifying day whether you’re in a great hospital in the U.S. in a high-income setting or in a low-income setting. It’s a scary day for moms, right?” French Gates said. “And you want to survive and you want your baby to survive."
Several low cost and low tech interventions would increase those chances of survival, according to a new report released Tuesday by The Bill & Melinda Gates Foundation that tracks progress towards the Sustainable Development Goals set at the United Nations in 2015.
Those include changes to the protocol for treating serious bleeding, known as postpartum hemorrhage, which is the leading cause of maternal death, treating anemia with a fast-working IV drip rather than tablets, and preventing infections with a specific antibiotic.
Dr. Rasa Izadnegahdar, who directs the foundation’s Maternal, Newborn & Child Health Discovery & Tools portfolio, called on the World Health Organization to speed up approval of some of the interventions, which in part are based on research and evidenced funded by the foundation. He also called for regulators around the world to strengthen quality controls around manufacturing drugs like oxytocin, which is used to control postpartum hemorrhage.
“The fact that the global community just tolerates some of this lower quality, substandard approach to women’s health is completely a gendered issue,” he said.
The foundation used modeling to estimate that the wide adoption of these maternal and child health interventions in low- and middle-income countries would save 2 million lives.
“It’s not an exaggeration to say that researchers have learned more about the health of mothers and babies over the past 10 years than they did in the century before that. Tragically, those solutions aren’t reaching families in the communities where mothers and kids need them most,” said Bill Gates and French Gates in the report’s introduction.
Big strides were made under Millennium Development Goals, the first set of goals set by the United Nations member states in 2000, on decreasing maternal deaths, but that has stalled and then slid backward since the onset of the pandemic. Most of the Sustainable Development Goals, which include reducing hunger, improving health and protecting biodiversity, are similarly off track as this year marks the halfway point to achieving them by 2030.
“Speaking bluntly, I think the world has lost a lot of focus and energy around the SDGs,” said Mark Suzman, CEO of the foundation, pointing to the pandemic, the war in Ukraine and economic problems like inflation as having diminished attention on health interventions.
The foundation would like to see world leaders, who will gather at the U.N. General Assembly later this month, recommit to the goals and to promise new funding to help meet them, Suzman said.
Tom Kenyon, chief health officer of Project HOPE, a global health nonprofit which has been funded by the Gates Foundation, lauded the foundation's long commitment to both research and then the implementation of solutions, which need to be adapted to the most local level.
“We have lots and lots of tools on the shelf, but it’s getting them to the sites where they’re needed, when they’re needed in a high quality manner,” he said.
The foundation’s work on public health and maternal mortality is focused on sub-Saharan Africa and South Asia. Besides raising awareness generally of the effectiveness of these interventions, it has no plans to fund their implementation in the U.S. But the foundation has stepped up its outreach to other governments and partners, Izadnegahdar said.
“We believe we need to be more proactive. I think to date, there’s been a approach of, ‘Let’s generate the evidence and that will be enough to reach a tipping point to shift,’” he said when asked what steps the foundation would take to help implement the report’s recommendations.
Gates and French Gates also noted the increasing rates of maternal deaths in the U.S. and United Kingdom and the racial disparities in those deaths. A recent study in the Journal of the American Medical Association found that maternal deaths doubled in the U.S. from 1999 to 2019, with Black mothers dying at the highest rate.
French Gates spoke with outrage about the harrowing experience tennis star Serena Williams described after giving birth to her first daughter and suffering multiple complications, which endangered her life.
“I mean, that just struck me. It was almost like a slap in the face,” said French Gates. “And then to see that we lost an Olympian this year, you know, 32 years old, who’s a track and field star?” referring to Olympic gold medalist Tori Bowie, who died in April from complications of childbirth and who had also lived with a serious mental illness.
“If those women aren’t being heard in our health care system, who you would think presumably have some voice, think about everybody else," she said. "No wonder we’ve got the maternal death rate we’ve got in our country.”
French Gates called on people around the world to speak up for the importance of good health care for women.
“There isn’t anything political about moms and babies. There just isn’t,” she said. "There isn’t anything political about wanting a mom to survive childbirth or for a baby to survive its first day.”
