Jolanta Scott-Parker
Executive Director, Canadian Federation for Sexual Health

On 10 May 2010 Jolanta Scott-Parker, Executive Director of the Canadian Federation for Sexual Health, IPPF’s Canadian Member Association, addressed Canada’s House of Commons Committee on the Status of Women. Scott-Parker appeared as a witness for the study of maternal and child health.  

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I would first like to thank the committee for the opportunity to appear today as a witness to address the topic maternal and child health. We are humbled to appear alongside the variety of esteemed organizations that have appeared both today, and on the other two days of hearings dedicated to this topic.

The Canadian Federation for Sexual Health- formerly Planned Parenthood Federation of Canada, is a national network dedicated to supporting access to comprehensive sexual health information, education and services in every community. We have member organization in a variety of communities across Canada and these members range from full service primary health care providers, to small information and education based organizations. Together they work dedicatedly to provide quality sexual and reproductive health information and services to the members of their community.

In addition to being a network of Canadian organizations, the Canadian Federation for Sexual Health is very proud to be the Canadian member organization of the International Planned Parenthood Federation. In fact, I am joined today by my colleague Pierre LaRamee from the IPPF Western Hemisphere Region in New York (although he is actually a Canadian) who will be pleased to participate in the question and answer period along with me.

IPPF is the world’s leading organization in sexual and reproductive health, with an unparalleled network of health providers in 171 countries. IPPF and its member organizations implement grassroots service delivery programmes that meet the reproductive health needs of the poor, marginalized, socially excluded/under-served.

All of those in the IPPF network welcomed the Canadian Government’s announcement that it will focus on maternal, newborn and child health as part of its G8 legacy initiative. We believe that this plan must be an integrated approach to saving women’s lives that includes comprehensive sexual and reproductive health services including access to modern contraception and safe abortion where abortion is legal. There is strong evidence to show that family planning saves lives. The World Bank estimates that 40 per cent of maternal deaths could be prevented by wider take-up of reliable contraceptive method.

For too long there has been little progress on maternal and child health and yet we have a strong international consensus about the actions required to make change. We also have a strong international commitment, (at least in principle) – we have simply lacked the political will and the financial investment. With unprecedented attention on this issue in the last 12 months, we have a tremendous opportunity to move forward with a new momentum.

To review quickly some of the facts that you have been presented with in recent days:

There are an estimated 215 million women worldwide who want to plan their families and cannot access family planning services. A dramatic improvement in access to contraception would dramatically reduce the number of unintended pregnancies, which would mean fewer pregnancy related deaths and complications.

I know Sharon Camp was here last week to speak to the new research from the Guttmacher institute which suggests that if we meet both the unmet need for contraception and the unmet need for maternal and newborn care services instead of the latter alone – that pregnancy related deaths could be reduced by 70%. (In this case it is also estimated that unsafe abortions would decrease from 20 million to 5.5 million).

The study suggests that meeting the combined need would actually be less expensive than simply meeting the need for maternal and newborn care. This cost saving would be as a result of the dramatic reduction in the need for pregnancy related care due to a reduction in unplanned pregnancies.

Somewhere between 530,000 women and 330,000 women die every year of complications related to pregnancy and childbirth (this range refers to recent research suggesting that some change may have occurred – which is very positive). It is estimated that 13% of these deaths are due to unsafe abortion. This represents as many as 70,000 deaths a year.

Contraception and safe abortion services must go hand in hand. In some instances access to contraception is not enough to ensure that women are exercising their right to control the timing and spacing of their children. This is true in cases of contraceptive failure, or in cases of rape or sexual coercion as well as a variety of other factors. In cases where abortion is legal – women must be offered access to this procedure safely.

At the 2009 G8,  Canada committed to ….”accelerating progress on maternal health, through sexual and reproductive health care and services and voluntary family planning”

Furthermore all of the G8 leaders signed onto the Consensus for Maternal and Child Health which agreed that the actions needed to address maternal and child health include a quality package of evidence-based interventions, delivered through effective health systems. These include:

• Comprehensive family planning advice, service and supplies
• Skilled care for women and newborns – during and after their pregnancy, as well as during childbirth. This must also include access to emergency obstetrical care
• Safe abortion services (where abortions are legal)
• Improved child nutrition and prevention and treatment of major childhood diseases.

The upcoming G8 meetings come at a critical time as world leaders also prepare to gather in September of this year to review the world’s progress on the Millennium Development Goals. MDG 5 and MDG 5b are the goals toward which the least progress has been made – and this G8 meeting provides a tremendous opportunity to change that.

Strong and effective civil society organizations are critical to ensuring the effective implementation of the Governments Maternal and Newborn Health Strategy. Civil society and governments must work together to ensure that we meet the Millennium Development Goals, and to ensure progress in sexual and reproductive health and rights.

Civil society organizations are often in a unique position to deliver specialized sexual and reproductive health services, especially to the poorest and most marginalized populations. IPPF and its member organizations are a critical component of the maternal health architecture, working in the world’s least developed countries to build capacity to deliver effective, high quality services from a rights-based perspective. 

The evidence is overwhelming and the global consensus clear with respect to what action is required.

In just over a month – I expect to give birth to my second child. I will do so within the Canadian health care system in the capable care of a midwife. If I am in the unfortunate position of experiencing a post-partum haemorrhage, as I did three years ago with the birth of my first child, I will seek emergency obstetrical care and be transferred to the care of an obstetrician gynaecologist.

I have a guaranteed form of transportation to the hospital, and can be assured that the roads will be passable when I need them. I can be assured that the tertiary care hospital that I will go to has blood products available, and a specialist on call 24 hours a day. A pregnancy related complication for me will be an unfortunate reality – but it will not likely threaten my life, or the long term well being of my family.

I am choosing to have my second child almost exactly three years after my first, and I have had the privilege of a variety of forms of modern contraception to assist me in making this choice. I also have fairly readily available access to abortion services had this not been a pregnancy that I was able to continue – for whatever reason.

All of the women of the world have the right to the same opportunities – to control their fertility and to safe pregnancy and childbirth.

Canada has an opportunity to demonstrate tremendous leadership on the world stage. Let us lead by example by investing in an integrated maternal, newborn and child health strategy that is built on evidence and that maximizes on its investment by providing comprehensive sexual and reproductive health services.