Caesarean sections have been lifesaving procedures for hundreds of thousands of women across the world who experience complications during labour.
Globally, it’s estimated that just under 20% of births take place via caesarean section – a percentage that’s gone up over the last three decades. This has raised concerns, particularly in high-income countries where generally too many caesarean sections are performed.
But in many African countries women who are medically required to have caesarean sections are not able to access them. This is due to several reasons, the most prominent being weak health systems and a lack of resources.
This needs to be fixed as women in sub-Saharan African suffer from the highest maternal mortality ratio in the world. Close to 550 women die for every 100 000 children that are born. This amounts to 200 000 maternal deaths a year – or two-thirds of all maternal deaths per year worldwide.
Imagine going through your day without ready access to clean water for drinking, cooking, washing or bathing. Around the world, 663 million people face that challenge every day. They get their water from sources that are considered unsafe because they are vulnerable to contamination, such as rivers, streams, ponds and unprotected wells. And the task of providing water for households falls disproportionately to women and girls.
I have carried out research in India, Bolivia and Kenya on the water and sanitation challenges that women and girls confront and how these experiences influence their lives. In my field work I have seen adolescent girls, pregnant women and mothers with small children carrying water. Through interviews, I have learned of the hardships they face when carrying out this obligatory task.
An insufficient supply of safe and accessible water poses extra risks and challenges for women and girls. Without recognizing the uneven burden of water work that women bear, well-intentioned programs to bring water to places in need will continue to fail to meet their goals.
So, what is it like for women who live in places where sufficient and safe water is not readily accessible?
After eight years of practicing obstetrics and researching childbirth in the United States, I know as well as anyone that the American maternal health system could be better. Our way of childbirth is the costliest in the world. Our health outcomes, from mortality rates to birth weights, are far, far from the best.
The reasons we fall short are not obvious. In medicine, providing more care is often mistaken for providing better care. In childbirth the relationship between more and better is complicated. Texan obstetricians, when compared to their counterparts in neighboring New Mexico, are 50% more likely to intervene on the baby’s behalf by performing a cesarean section. Nonetheless, Texas babies still have a lower survival rate than New Mexican babies.
I long assumed that our most puzzling American health care failures were idiosyncrasies–unique consequences of American culture, geography, and politics. But a trip to India for the 2017 Human Rights in Childbirth meeting led me to a humbling realization: when it comes to childbirth, both countries fall short in surprisingly similar ways.
Human rights in childbirth
I take care of patients in at a well-funded teaching hospital in Boston, where pregnant women seem well-respected and have clear, inviolable rights.
Every 28 days, millions of girls and women in developing countries miss school or work – up to 50 days per year – because they lack access to affordable menstrual products. And, it’s not just a problem in poor countries. Right here in the United States, women and girls who lack means often need both menstrual health education and reusable menstrual products.
The eight companies and organizations provide menstrual products in the United States and in Africa. Here are ways you can help them on their missions to provide women and girls with products that simply make their lives easier.
AfriPads Foundation: If you would like to ensure that a girl in Africa receives a full year menstrual kit, you can donate monthly, yearly, or just once. AfriPads are reusable pads manufactured in Africa that employs local Ugandan women. To support one girl for one year and ensure her school attendance the cost is only 5 Euros or $5.38 currently. Donate here: www.afripadsfoundation.org
Aunt Flow: When you buy a subscription box of menstrual pads and tampons another subscription box will be donated to a beneficiary organization that provides menstrual relief for women and girls who need it. When you purchase your subscription box, you can choose the organization where your donated box will be gifted. You can choose monthly, 6 months and annual plans www.auntflow.org
Conscious Period: If you exclusively use tampons, you might want to opt for alternative products other than the mass marketed ones you find in every drug and grocery store. Conscious Flow provides tampons that are exclusively created with 100% organic cotton with BPA-free applicators. For every box of Conscious Period tampons you buy, a box will also be gifted to a homeless woman in the United States. consciousperiod.com
Glad Rags: A sustainably focused Oregon company that provides cloth menstrual pads and menstrual cups, Glad Rags provides eco-friendly products for women and girls. Glad Rags gives back by working specifically with Untabooed, an organization that educates women and girls about menstrual health and provides reusable menstrual products to women in the New York City area. www.gladrags.com
Huru International: For only $35 you can purchase a Huru International menstrual kit for a girl in Kenya or Tanzania. The kit includes eight reusable pads, 3 pairs of underwear, an infographic on proper sanitary pad usage, a waterproof bag to safely store used sanitary pads, soap to wash the sanitary pads and a life-skills educational booklet. Supporting Huru International not only allows girls to strive as they matriculate through school, but also supports its employees in its manufacturing facility in Mukuru slum in Nairobi, Kenya. www.huruinternational.org
Luna Pads’ One 4 Her Program: Girls in schools in low- and middle-income countries tend to stay home from school when they begin to menstruate. Their periods become especially hard to manage because many cannot afford pads or even tampons. And, even if they can, frequently changing their pad is very difficult as boys and girls often share the same bathroom facilities. When shopping at Luna Pads, a company that creates sustainable alternatives to disposable menstrual products, your purchase provides a cloth menstrual pad for a girl in need through their partnership with AfriPads. One4Her also provides menstrual health education and employment opportunities for Ugandan women. lunapads.com/one4her
Ruby Cup: One of the most well-known alternatives to reuable tampons and menstrual pads is the Ruby Cup. It is eco-friendly and cost-effective menstrual pad. When you buy one Ruby Cup, one is donated to a girl in East Africa. The Ruby Cup also allows a young girl to wear it during their period without the panic of running out of tampons or pads and they don’t have to throw it away contributing to more waste in their communities. www.rubycup.com
SHE (Sustainable Health Enterprises): SHE has created an innovative way for banana farmers in Rwanda to use the banana husks they discard to produce menstrual pads for girls. SHE provides both jobs for workers, pads for Rwandan girls in schools, and also menstrual education. You can donate directly to SHE to support their efforts in Rwanda. sheinnovates.com
There are many businesses and organizations out there doing great menstrual health work. As we discover more of them we’ll add them below because many give back to various regions of the world. Some focus on developing countries while others concentrate on providing quality menstrual products to low-income women and girls right here in the United States.
Eco Femme: Eco Femme is a global women’s empowerment project promoting menstrual practices that are healthy, dignified, affordable and eco positive to India’s women and girls. A social enterprise, Eco Femme’s pads are locally produced in India. They also provide much-needed menstrual education to girls and disadvantaged women. For every Eco Femme pad purchased, Eco Femme is able to provide cloth pads to Indian girls who need them.
LOLA: LOLA provides 100% organic cotton tampon subscription service. All of their feminine products are created without dyes and additives. Additionally, their tampon applicators are BPA-free. With your subscription LOLA donates menstrual products to low-income women and girls in the United States. To date they have donated 100,000 tampons since 2015.
Photo: Jennifer James School girls in Zambia conducting a reproductive health class with their peers