Barriers to maternal health care

Despite the clearly demonstrated need for family planning and maternal health services, women often lack access to relevant information, trained providers and supplies, emergency transport, and other essential services. Furthermore, cultural attitudes and practices may impede women's use of services that are available. Decisions about whether to seek care are generally not the woman's alone, but are often made by the husband or mother-in-law (Thaddeus and Maine 1990; Huque and Koblinsky 1991).

Most pregnant women in the developing world receive insufficient or no prenatal care and deliver without help from appropriately trained health care providers. Only about half of the married women of reproductive age in the developing world practice contraception. In some countries in Africa, family planning and maternity care coverage is less than 10 percent (WHO 1992e). Even in countries with relatively well-developed health systems, preventable maternal morbidity and mortality persist. A study of four institutions in Mexico City classified 85 percent of the maternal deaths examined as potentially preventable; clinical or surgical misjudgement was blamed for more than eight out of ten of the preventable deaths (Bobadilla 1992).