Dangers to women. Moral issues of our time.

[Pure]

So as not to hijack the thread alleging the Muslim women's condition is one of the most important or salient of 'oppressions,' I've started this one. Of course, where there is human suffering, 'manmade' so to say, I agree with Roxanne, it's to be pointed out. Further acted upon.

I think, aside from 'second class status' or 'arranged marriage,' or even 'honor killing,' the main dangers to women are from diseases and childbirth. (AIDS and malaria have been mentioned elsewhere.)

Bearing children is in the life of most women, and in the 'third world', it's quite risky; a woman may, considering she has several children, have a 1 in 10 chance of dying for those related causes. 26,000 women died in Pakistan in the year 2000, from maternal related causes. If there were, in Pakistan, 200, or even 2000 'honor killings', the problem pales by comparison with the much greater sources of danger.

It's being discussed in another thread whether 'organized religion' is a danger to women or source of misogyny. I don't see that 'religion' [or Islam in particular] as compared to cultural and national development is a main source of the most life threatening events for women.

The dangers of disease and childbirth, further, are remediable, as the statistics for W. Europe show. It's simply a matter of 'does anyone care?' 'does anyone care enough to spend a nickel?'

http://www.unfpa.org/upload/lib_pub_file/237_filename_mm2000.pdf

Maternal Mortality in 2000; estimates by WHO, UNICEF, UNFPA
(WHO; Geneva, 2004)

This discussion is based on Table G, column 4. (Lifetime risk of maternal death).
(Another column of interest is the maternal mortality ratio --column 5--, i.e., deaths per 100,000 livebirths.)

One statistic of interest in women’s health is the risk of dying in childbirth. There is the risk on one occasion, and the lifetime risk (cumulative. The LOWER the number, the worse it is. For example, in the figures below, in Afghanistan, the figure is 6. That means a woman has a 1 in 6 chance of dying in childbearing over her life.

In the developed countries of US and W. Europe, the numbers are in the 1000s. That means a woman has a 1 in a 1000+ chance of dying for these reasons. In Germany, a woman has 1 chance in 8,000 of so dying.

In the developing countries of Africa, the numbers are generally in the double digits. Thus Subsaharan Africa is generally the most dangerous for women, in this regard.

In the moslem world, Pakistan is least well off with a 1 in 30 chance of dying.
Other countries such as Saudi Arabia have figures like 1 in 600. For Iran, the figure is 370. So much of the muslim world is in the triple digits (100s).


Some of the worst parts of the world are
Subsaharan Africa
Zambia 19
Tanzania 10

Muslim and/or Arab countries
Afghanistan 6! [a LOW number is bad]
Pakistan 31
Iran 370
Saudi A. 610
Morocco 120

W. Europe:
Germany 8000 [a high number is good!]
Norway 2900
Netherlands 3500

UK 3800

North America
US 2500
Canada 8700

 

[cumallday]

a question of economics?

Women own 1% of the world's wealth. Yes, you read correctly - 1%. Imagine how different the world would be if you added 49% more.

 

[Pure]

what we forget is that in many parts of the world, simply being pregnant and giving birth is life threatening to women. dying in this period is rare in the developed world: for the UK about 10 in 100,000 births. (1 in 10,000 per birth).

in the original posting, i mentioned that an Afghan woman has 1 in 6 chances of dying through pregnancy or giving birth to a typical number of children.

assume that number is 6. doing the math X**6= .87, one gets about 98% chance of living, per child, assuming the risk is evenly distributed. IOW, very roughly, she has a 1 in 50 chance of dying with each child.

the exact statistic for Afghan women dying thus is a stunning:

1600 maternal deaths in 100,000 births, which works out to 1 in 62, for any given birth (or before).

That's about 20,000 women dying thus, per year.

 

[Selena_Kitt]

what we forget is that in many parts of the world, simply being pregnant and giving birth is life threatening to women. dying in this period is rare in the developed world: for the UK about 10 in 100,000 births. (1 in 10,000 per birth).

in the original posting, i mentioned that an Afghan woman has 1 in 6 chances of dying through pregnancy or giving birth to a typical number of children.

assume that number is 6. doing the math X**6= .87, one gets about 98% chance of living, per child, assuming the risk is evenly distributed. IOW, very roughly, she has a 1 in 50 chance of dying with each child.

the exact statistic for Afghan women dying thus is a stunning:

1600 maternal deaths in 100,000 births, which works out to 1 in 62, for any given birth (or before).

That's about 20,000 women dying thus, per year.

But the statistics for the U.S. are quite off. Why?

According to the WHO, "A maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes."

Both ACOG and the CDC have refused to use WHO's definition of maternal death.

According to WHO:

The major causes of maternal death are bacterial infection, toxemia, obstetrical hemorrhage, ectopic pregnancy, puerperal sepsis, amniotic fluid embolus, and complications of abortions.

As stated by the 2005 WHO report "Make Every mother and Child Count" they are: severe bleeding/hemorrhage (25%), infections (13%), eclampsia (12%), obstructed labor (8%), complications of abortion (13%), other direct causes (8%), and indirect causes (20%). Indirect causes such as malaria, anaemia, HIV/AIDS and cardiovascular disease, complicate pregnancy or are aggrevated by it.

That last 20% isn't counted here in the US under our maternal death statistics.


Also, just so you're aware, the number you're quoting are from the MMR: Maternal Mortality RATIO. They aren't the ACTUAL maternal death rate.

 

[Pure]

maybe you can explain a bit more. the report has many variables and models and extrapolations (as is inevitable). i decided to focus on MMR, table G.

what numbers (and columns) should we look at? which countries besides African, are most dangerous to women? is the US behind W. Europe in protecting the life of mom during pregnancy and childbirth?

==
Indirect causes such as malaria, anaemia, HIV/AIDS and cardiovascular disease, complicate pregnancy or are aggrevated by it.

That last 20% isn't counted here in the US under our maternal death statistics.

I can see the virtue of the US approach *for a developed country.* In any case, whether 'indirect' is included just needs to be specified by the table makers, and kept in mind.

I'm sure the African data are sufficiently staggeringly bad *even if* you don't count (fatal) exacerbations of malaria,etc.
===

Just for discussion, here are the definitions of the report cited above:

Measures of maternal mortality

There are three distinct measures of maternal mortality in widespread use: the maternal mortality ratio, the maternal mortality rate and the lifetime risk of maternal death. The most commonly measure is the maternal mortality ratio, that is the number of maternal deaths during a given time period per 100,000 live births during the same time period. This is a measure of the risk of death a woman has become pregnant.

The maternal mortality rate, that is, the number of maternal in a given period per 100,000 women of reproductive age during the same time period, the frequency with which women are exposed to risk through fertility.

The lifetime risk of maternal death takes into account both the probability of becoming pregnant and the probability of dying a result of that pregnancy cumulated across a woman’s reproductive years. In theory, the risk is a cohort measure but it is usually calculated with period measures for practical reasons. be approximated by multiplying the maternal mortality rate by the length of the reproductive (around 35 years). Thus, the lifetime risk is calculated as [1-(1-maternal mortality rate)35].

 

[ChristopherMaxwell]

Women own 1% of the world's wealth. Yes, you read correctly - 1%. Imagine how different the world would be if you added 49% more.

With all of the hefty divorce settlements, I had thought they already did. Bloody bollocks! Is THAT why they're trying to shaft their exes? Still not in favor of it though.

On a different note, this is a sad reality, most distinctly furthered by the fact that many women actually support policies that oppress themselves (female circumcision and such). I can't for the life of me figure that out. It must be their tendency to accept the status quo and reject changes in social mores.

 

[Selena_Kitt]

what numbers (and columns) should we look at? which countries besides African, are most dangerous to women? is the US behind W. Europe in protecting the life of mom during pregnancy and childbirth?

The MMR is still a good indicator... I just wanted people looking at the stats to be aware that it's a ratio rather than a rate.

Africa and Afghanistan are, indeed, the worst... but remember that HIV deaths are counted in maternal death rates, and in Africa, those numbers are huge. They're not counted here in the U.S. (and are nowhere near the numbers, either, of course)

WHO says: On the basis of the present exercise, the estimated number of maternal deaths in 2000 for the world was 529,000. These deaths were almost equally divided between Africa (251,000) and Asia (253,000), with about 4% (22,000) occurring in Latin America and the Caribbean, and less than 1% (2,500) in the more developed regions of the world. In terms of the maternal mortality ratio (MMR), the world figure is estimated to be 400 per 100,000 live births. By region, the MMR was highest in Africa (830), followed by Asia (330), Oceania (240), Latin America and the Caribbean (190), and the developed countries (20).

That said, still, the US is behind most of W Europe in protecting the life of the mother (and infant... they're correlational) during pregancy and childbirth. If you look at the table, our number is 17 (per 100,000 births). For a DEVELOPED nation, we suck. Look at Denmark (5) Finland (6) Germany (8) Ireland (5) Sweden (2!!)

 

[Pure]

so do these half million maternal deaths per year rise to the level of a major moral problem of our time?

 

[Selena_Kitt]

so do these half million maternal deaths per year rise to the level of a major moral problem of our time?

They should.

Whether they DO is a different question altogether.

You can tell from the response to this thread what a "hot" topic this is...

 

[Pure]

it's an odd US custom and worldview that if no one directly kills someone, then her death is 'natural causes.' No person or persons are responsible.

i have some comparative figures on 'honor killings'--for which a person can be identified as the killer. world estimates (UN) are on the order of 5000. Pakistan estimates are in the 500-1000 range. these--the more notable ones-- receive LOTS of attention in the Western press and by Western feminists.

childbirth deaths are 'God's Will.'
---

yes, this thread is not the sexiest; it has all the floating power (attractiveness) of the proverbial 'lead balloon.'

 

[SeaCat]

Oh if it were true that these were the only dangers to women.

Yes these are bad, no they are worse than that but they can be dealt with.

What to me is even worse moraly is the dangers women face and deal with in the so called civilized countries.

Rapes, sexual abuse and Domestic Violence.

Many in the so called civilized countries turn a blind eye to it. They allow such defences as "she was asking for it because of the way she was dressed." Or, "Well she was asking for it by walking through that neighborhood", or "Maybe she pushed him to beat her."

Cat

 

[Trinique_Fire]

oh my fucking god.

 

[Pure]

yes, seacat, would be interesting to have a figure for the US for domestic violence (deaths). today's (Canada) paper had a variation: family murder. man killed wife, daughter, self.

===
Here are a few US figures:

http://www.endabuse.org/resources/facts/

· Intimate partner violence is primarily a crime against women. In 2001, women accounted for 85 percent of the victims of intimate partner violence (588,490 total) and men accounted for approximately 15 percent of the victims (103,220 total).8

· While women are less likely than men to be victims of violent crimes overall, women are five to eight times more likely than men to be victimized by an intimate partner.9

· In 2001, intimate partner violence made up 20 percent of violent crime against women. The same year, intimate partners committed three percent of all violent crime against men.10

· As many as 324,000 women each year experience intimate partner violence during their pregnancy.11

· Women of all races are about equally vulnerable to violence by an intimate.12

· Male violence against women does much more damage than female violence against men; women are much more likely to be injured than men.13

· The most rapid growth in domestic relations caseloads is occurring in domestic violence filings. Between 1993 and 1995, 18 of 32 states with three year filing figures reported an increase of 20 percent or more.14

· Women are seven to 14 times more likely than men to report suffering severe physical assaults from an intimate partner.15

Domestic Homicides

· On average, more than three women are murdered by their husbands or boyfriends in this country every day. In 2000, 1,247 women were killed by an intimate partner. The same year, 440 men were killed by an intimate partner.16
====

sources:
8Bureau of Justice Statistics Crime Data Brief, Intimate Partner Violence, 1993-2001, February 2003

9U.S. Department of Justice, Violence by Intimates: Analysis of Data on Crimes by Current or Former Spouses, Boyfriends, and Girlfriends, March 1998

10Bureau of Justice Statistics Crime Data Brief, Intimate Partner Violence, 1993-2001, February 2003

11Gazmararian JA, Petersen R, Spitz AM, Goodwin MM, Saltzman LE, Marks JS. “Violence and reproductive health; current knowledge and future research directions.” Maternal and Child Health Journal 2000;4(2):79-84.

12Bureau of Justice Statistics, Violence Against Women: Estimates from the Redesigned Survey, August 1995

13Murray A. Straus and Richard J. Gelles, Physical Violence in American Families, 1990

14Examining the Work of State Courts, 1995: A National Perspective from the Court Statistics Project. National Center for the State Courts, 1996

15National Institute of Justice and Centers for Disease Control and Prevention, Prevalence, Incidence, and Consequences of Violence Against Women: Findings from the National Violence Against Women Survey, November 1998

16Bureau of Justice Statistics Crime Data Brief, Intimate Partner Violence, 1993-2001, February 2003

 

[Pure]

"Pregnancy can be dangerous to your health. " --Laci P.

· Pregnant and recently pregnant women are more likely to be victims of homicide than to die of any other cause18 , and evidence exists that a significant proportion of all female homicide victims are killed by their intimate partners.19
---
sources
18Horon, I., & Cheng, D., (2001). Enhanced Surveillance for Pregnancy-Associated Mortality - Maryland, 1993 - 1998. The Journal of the American Medical Association, 285, No. 11, March 21, 2001.

19Frye, V. (2001). Examining Homicide's Contribution to Pregnancy-Associated Deaths. The Journal of the American Medical Association, 285, No. 11, March 21, 2001
----


Murder most foul

Medical researchers now believe that homicide, not medical complications, is the leading cause of pregnancy-associated death.

By Mary Papenfuss

February 27, 2003 | Laci Peterson was due to give birth to a baby boy -- her first child -- this month. Instead, the 27-year-old Modesto mother-to-be is presumed dead. Her body is missing; her husband, though not an official suspect in his wife's disappearance, is under intense scrutiny by detectives in the case. Weary volunteers, scouring land and water since Peterson's disappearance Christmas Eve, focused on the New Melones Reservoir last weekend.

Police searched the Peterson home for the second time early last week, removing several bags of evidence. Any hope that Laci and her baby are alive has nearly evaporated. "When we're looking in places under water, we're looking for a body," reported Police Chief Roy Wasden.

There's much for a woman to fear when she's pregnant -- the "What to Expect When You're Expecting" books gingerly spell out the many medical hazards in chapters too frightening for some women to read: preeclampsia, miscarriage, stillbirth, stroke and hemorrhage are complications that American women, many of whom enjoy some of the best prenatal care in the world, are familiar with.

But what the pregnancy manuals don't mention is a chilling fact that has been buried in death statistics for many years: Murder is now believed to be responsible for more pregnancy-associated deaths in this country than any other single cause, including medical complications such as embolism or hemorrhaging.

For decades, the medical community has limited its definition of "pregnancy-related death" to fatal medical complications, and law enforcement has followed suit, failing to collect separate data on whether female homicide victims were pregnant. The absence of murder as a category of pregnancy-related -- or more accurately, pregnancy-associated death -- left a void where a significant medical and social concern had been brewing for years.

"We aren't doing a good job yet of surveillance of pregnancy-associated deaths," says Dr. Cara Krulewitch, an epidemiologist at the University of Maryland in Baltimore, who was among the first researchers to find a link between pregnancy and homicide. "The system isn't in place because pregnant women are supposed to be healthy.

"We don't expect them to die -- or be killed," she says, "but it's beginning to change -- there's a sense that the number of deaths may be significantly higher -- with a frightening number caused by homicide."

And as the numbers of pregnant women murdered every year are revealed, so, too, are their murderers. Homicide is the fourth leading cause of death among all American women of childbearing age; and one-third of all female murder victims each year are killed by an intimate partner. As pioneering medical researchers reexamine death reports of murdered women, looking for signs that the victim was pregnant, they are concluding that often, the killer of a pregnant woman is the partner or spouse of the mother-to-be.

"Why are pregnant women dying?" asks Rebecca Whiteman of the Family Violence Protection Fund in San Francisco. "Their partners are killing them."
- - - - - - - - - - - -
Historically, deaths defined as "pregnancy-related" were deaths caused by a medical complication of pregnancy, or deaths that occurred when pregnancy aggravated an existing health problem. Traumatic deaths of pregnant women -- deaths due to injury, accident or violence -- have generally not been systematically collected or examined.

The result is an almost complete lack of accurate national statistics about the number of pregnant women murdered or the circumstances of their deaths. In the absence of those numbers, researchers have begun to compile data, often on a state-by-state basis, by recovering and then scrutinizing old death records and murder reports.

Cara Krulewitch, who is also a nurse and midwife, suspected for years that pregnancy-associated deaths -- a phrase that, unlike "pregnancy-related," includes deaths associated not just with medical complications in pregnancy but with trauma, including murder -- were underreported. In an initial study in the Journal of Midwifery and Women's Health, she took a look at death records in Washington, D.C., over an eight-year span. She was shocked by her discovery that 14 of 35, or 38 percent, of pregnant women who died in Washington from 1988 to 1996 were victims of homicide.

She also found that, during that same period, the Washington Center for Health Statistics reported only 21 of those pregnancy-related deaths, those who died from medical causes. The 13 homicide victims that Krulewitch found were reported simply as murder victims. Their pregnancy status wasn't noted on their death certificates.
"I was stunned by what I saw," says Krulewitch.


In a 2001 study published in the Journal of the American Medical Association, researchers in the Maryland Department of Health and Mental Hygiene found that between 1993 and 1998, homicide was responsible for more pregnancy-associated deaths in Maryland than any single medical cause, accounting for 20 percent of all pregnancy-associated deaths. Homicide accounted for twice as many deaths as the most common medical cause -- embolism.

More recently, in a study to be published in May in Child Maltreatment, a journal of the American Professional Society on the Abuse of Children, Krulewitch also focused on Maryland, attempting to calculate the risk for pregnant women in that state of being murdered during, or in the year after, a pregnancy. Looking at all female victims of murder in Maryland between 1994 and 1998, Krulewitch found that pregnant women were disproportionately represented. Comparing the percentage of women in the total female population who were pregnant to the percentage of murder victims who were pregnant, Krulewitch found that pregnant women were twice as likely to be murdered as non-pregnant women of the same age.

A 2002 study in the Journal of the American Medical Women's Association also found that homicide was the leading cause of pregnancy-associated deaths in Massachusetts from 1990 to 1999. They also determined that the rate of pregnancy-associated deaths -- not necessarily homicides -- was at least three times higher for African-American women, and all women younger than 25 and between the ages of 40 to 44.