An historical overview of the first two decades of striving towards Safe Motherhood

The paper examines some of the progress and problems encountered during the first two decades of the Safe Motherhood Initiative. Sufficient statistics are cited to identify the immensity of the persisting problems associated with maternal death and morbidity before the study focuses on some of the endeavours designed to enable women to survive their natural function of giving birth. Varying attitudes and approaches that have characterised the initiatives launched in the past 20 years are reviewed and their changing emphases noted. The stress on treating the medical causes of maternal death in the early years have been complemented by increasing attention to social and political issues as time has elapsed. The advent of the Millennium Development Goals (MDGs) has impelled efforts to provide skilled attendance for all women during childbirth; the poor, socially disadvantaged and vulnerable being those most at risk. MDG 5, concerning maternal health, is perceived as pivotal in the context of global development. Maternal death when viewed from the human rights perspective is perceived as a social injustice rather than a health disadvantage and Safe Motherhood is currently considered increasingly as a basic human right. The study offers a synthesis of concepts and actions that are contributing to building Safe Motherhood across the globe in the 21st century. In considering the factors that inhibit the degree of safety associated with giving birth, global efforts that are tackling a persisting buffer zone are identified and continuous action urged in order to strive towards the targets set for 2015.