6 Improve maternal health

Where we are?

 pregnant woman
Despite declining trend, maternal mortality rate in the country remained high. (Photo: UNICEF Philippines)

Based on the country progress on all indicators, the Philippines is in critical danger of not achieving the target on improving maternal health by 2015. While the maternal mortality rate (MMR) had been declining over the past two decades, from 209 per 100,000 live births in 1993 to 172 in 1998 to 162 in 2006, the rate of change has been relatively low (NDHS, NSO 1993, 1998; FPS, NSO 2006). In addition, the decline appears to have stalled making the target reduction in MMR of 52 deaths per 100,000 live births by 2015 highly improbable.

The high rate of maternal deaths may be attributed to inadequate access to integrated reproductive health services by women, including poor adolescents and men.

For one, significant number of Filipino women lack access to qualified reproductive health services. Over half of births in the country occurred at home, and a third of them were assisted by traditional birth attendants. Poor women are greatly disadvantaged with around 75 percent of the poorest quintile have no access to skilled birth attendants compared to only 20 percent of the richest quintile.

In 2006, the country’s total fertility rate was at 3.2 births per woman, a slight decline from the 2003 rate of 3.5 (FPS 2006). However, of the three million pregnancies that occur each year, half were unplanned, of which, one-third end in abortions. Young women accounted for 17 percent of this (Allan Guttmacher Institute). Induced abortion is one of the leading causes of maternal deaths in the country.

While survey findings reveal that Filipino women desire fewer children and would like to use modern contraceptives, only half of them practice family planning (FP). From 2001 to 2006, the contraceptive use of women of reproductive age has remained almost unchanged at 49 and 50.6 percent respectively (FPS 2001, 2006). Despite showing improvement, unmet need for family planning remained high at 15.7 percent (FPS 2006). Even when FP services are available, it has been observed that the decision to seek health services is often determined by gender norms in the family and community, as well as cultural and religious beliefs and practices.

Early pregnancy is also a problem. In 2006, 6.3 percent of teenaged women (15-19 years old) had begun childbearing, majority of them were poor and from the rural areas (FPS 2006). From 1994 to 2002, prevalence of pre-marital sexual activity among young adults increased from 18 percent to 23 percent, yet contraceptive use remained low (YAFSS 1994, 2002). This further leads to unwanted pregnancies and induced abortions, and consequently maternal deaths.

These trends indicate the need to actively promote family planning and responsible parenthood most especially for low-income households and young people.

Maternal Mortality Rate, 1993, 1998 and 2006

Bar Chart

Sources of data: NDHS, NSO (1993, 1998); FPS, NSO (2006)

Targets for MDG 5
  1. Reduce by three quarters the maternal mortality ratio
    • Most maternal deaths could be avoided
    • Giving birth is especially risky in Southern Asia and sub-Saharan Africa, where most women deliver without skilled care
    • The rural-urban gap in skilled care during childbirth has narrowed
  2. Achieve universal access to reproductive health & inadequate funding for family planning is a major failure in fulfilling commitments to improving women’s reproductive health
    • More women are receiving antenatal care
    • Inequalities in care during pregnancy are striking
    • Only one in three rural women in developing regions receive the recommended care during pregnancy
    • Progress has stalled in reducing the number of teenage pregnancies, putting more young mothers at risk
    • Poverty and lack of education perpetuate high adolescent birth rates
    • Progress in expanding the use of contraceptives by women has slowed & use of contraception is lowest among the poorest women and those with no education