In The Mother and Child Project, Melinda Gates, Kay Warren, Tony Campolo, Christine Caine, and Senator William H. Frist, along with other inspirational leaders, cultural icons, political experts, academics, and service providers, provide a personal yet fact-based narrative exploring the plight of women and children living in extreme poverty in an effort to educate and inspire the church to speak up in support of maternal and child health issues in the developing world.
Dozens of influential leaders have heard the pleas of mothers and children in developing countries. Raising their voices to inspire a movement to increase healthy pregnancies and lower death rates, Melinda Gates, Kay Warren, Bill Frist, Kimberly Williams Paisley, Michael W. Smith and more speak out about why people of faith must get involved in The Mother and Child Project: Raising Our Voices for Health and Hope. Almost 287,000 women die each year because of pregnancy and birth complications. Many orphans are left behind in the wake of this tragedy, and without a mother, many of those children die as well. If only enough people knew. We have the resources to prevent this crisis, but we must take action.
Fortunately, Hope Through Healing Hands, a nonprofit organization promoting awareness for healthy mothers and children worldwide, is already spreading the word. Not only can we save lives, reduce abortions, and decrease death rates, but also we can help build healthier, thriving families and bring stability and sustainability to families, communities and nations.
The question is, will you join them?
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The Mother and Child Project
By Jenny Eaton Dyer
ZONDERVANCopyright © 2015 Zondervan
All rights reserved.
A Mama Knows
Rachel Held Evans
A mama knows ...
A mama knows the difference between a playful coo and a hungry whimper, a real fever and a valiant attempt to get out of school. She can spot a secret in the curl of a smile, a lie in the shift of the eyes, an impending illness in the subtle tilt of a head. She knows the rhythms of the household—the patter of toddler feet on the floor, the hurried scratches of forks against empty plates, the sweet and steady sucking of a baby at the breast. And she knows the rhythms of her own body, when it is heavy with milk, sore from cramps, exhausted from labor, in need of rest. A mama knows when something isn't right.
A mama keeps a mental inventory of the resources, turning the numbers over in her mind at night, willing there to be enough food for each belly, enough money for the girls to go to school, enough medicine at the clinic, enough energy to get through the next day. She knows the weight of a baby in her womb and a toddler on her back and how it affects her ability to work in the fields, to walk miles to fetch clean water, to care for the others. A mama knows what is best for her family, and so a mama is strongest when she is empowered to make good decisions for them.
But not every woman gets to choose. Not every mama gets the chance to do what she knows is best for herself and her family. There are more than 220 million women in developing countries who don't want to get pregnant, but who lack access to the family planning information and contraceptives many of us take for granted. Every year, nearly 300,000 of them will die during pregnancy or from complications giving birth, and many more will be permanently disabled. Far too many mothers will bury their babies before they even get to know the sound of their laughter or the tenor of their cries. More than 2.6 million babies will be stillborn, and another 2.9 million will die before they are a month old.
Giving women the opportunity to time their pregnancies and space out their children through effective, low-cost contraception is key to turning these heartbreaking numbers around. In fact, some believe it could save as many as 2 million children every year. Not only does access to family planning information and contraception improve the health of mothers and children, but it also improves the economies of their households. When a woman has fewer children and more time to work harvesting crops or growing her fledgling business, she brings more resources into the home so her children can be fed and go to school. If a poor family must weather a drought or famine, they are more likely to survive with a smaller household and fewer mouths to feed.
These are things that every mother knows instinctively, and yet ensuring that every woman has access to the contraception options she wants is not always a top priority on the global health agenda.
That's because conversations about contraception, particularly here in the United States, tend to be religiously and politically charged. Some people seem to think that family planning is just code for abortion, when it's not. Others presume that giving women access to contraception is encouraging them to behave promiscuously, even though most of the women who use oral contraceptives are married. Still others get caught up in domestic debates over insurance coverage and religious freedom and who should pay for what. Words like entitled, selfish, and even slut get thrown around, our perspectives tragically skewed by our own luxury of choice.
But a woman who wants to live long enough to see her children grow up isn't being selfish. A woman who wants to provide an education for her girls as well as her boys isn't acting entitled. A woman who wants to space out her pregnancies so her newborns have a better shot at life isn't a slut. And we cannot allow simplistic, self-focused narratives about contraception and family planning to keep us from helping these women, from ensuring they have the opportunity to choose.
For those of us who identify as pro-life, it's not enough simply to oppose abortion. We must also actively advocate for and invest in those specific actions that not only curb the abortion rate but also save the lives of women and children worldwide. Increasing access to family planning information and contraceptives will result in fewer women and girls dying in pregnancy and childbirth, fewer unintended pregnancies, fewer abortions, and fewer infant deaths. This is why I am convinced that a consistent pro-life ethic must include promoting access to effective and affordable contraception. Millions of lives, of both the born and the unborn, are at stake.
As Christians, we are called to reorient our perspective around the needs of the most vulnerable, those whom Jesus called "the least of these." But the truth is, when we lean in close, we learn that "the least of these" aren't all that different from ourselves. The mothers of sub-Saharan Africa chuckle the same way over the antics of their mischievous children as do mothers here in the United States. The women of Southeast Asia share the same instincts and intuition as women in Europe, women in South America, women from centuries past, and women from centuries to come.
A baby's death is no less tragic when it happens quietly on a dirt floor than when it happens in a high-tech hospital amid a web of ventilators and tubes. We may have dissimilar circumstances, but we share a common humanity, a shared dream of raising healthy and happy families.
Melinda Gates often tells the story of a Kenyan mother named Maryanne who spoke with Gates about her community's struggle to get access to contraception. "I want to bring every good thing to this child," Maryanne told her, "before I have another."
A mama knows.
A mama knows when it is time to grow a family and when it is time to wait. A mama knows how far the rations will stretch, how much school uniforms cost, how long she ought to nurse her baby. A mama knows when her body needs a rest. And a mama knows how to bring every good thing to that little boy whose head nestles into her soft, waiting shoulder.
Let's give her the chance to do it.CHAPTER 2
Contraception Is a Pro-Life Cause in Developing World
Bill Frist and Jenny Eaton Dyer
When it comes to the health of children and mothers worldwide, there are immense challenges, yet many signs of hope.
Over 6.9 million children die every year in the developing world from preventable, treatable causes. While the loss of these children is a tragedy of epic proportions, the good news is that over the last six years, this number has been lowered by 35 percent. We know we can combat newborn mortality and enhance child survival. Simple, low-cost measures are being taken to ensure better health for these children around the world. Measures like oral rehydration therapy, bed nets to prevent malaria, and access to immunizations have accelerated the rate of reducing child mortality in developing nations.
With an increased focus on maternal, newborn, and child health over the past few years, the global community has seen real progress against daunting challenges. An underappreciated part of that story is healthy birth spacing and timing, or family planning, which has a profound effect on the survival and quality of life of both mothers and children. As Michael Gerson, former speechwriter for President George W. Bush and Washington Post columnist, puts it, "family planning is a pro-life cause."
When we talk about voluntary family planning in the international context, what do we mean? The definition I use is enabling women and couples to determine the number of pregnancies and their timing, and equipping women to use voluntary methods for preventing pregnancy, not including abortion, that are harmonious with their values and beliefs.
It shocks Americans to learn that 1 in every 39 childbearing women in sub-Saharan Africa dies in childbirth. However, when a woman delays her first pregnancy until she is at least eighteen, her chances of surviving childbirth increase dramatically. If she can space her pregnancies—through fertility-awareness methods (sometimes called natural family planning) or modern contraceptive tools—to at least three years between births, she is more likely to survive and her children are more than twice as likely to survive infancy.
The Center for Strategic and International Studies (CSIS) hosted a delegation in February 2014 for congressional staff, foundation, and nonprofit leaders, including Jenny Eaton Dyer, to see the emerging success of family planning in Ethiopia. With the infrastructure of their path-breaking Health Extension Worker (HEW) program, training 38,000 women as health workers in just a few years, women in the most rural communities now have access to antenatal care and family planning. With a Health Post designated for every 5,000 people, women have access to tools for healthy timing and spacing of pregnancies without having to walk for miles to a higher-level health facility. In less than a decade, since 2005, Ethiopia's contraceptive prevalence rate has nearly doubled, from 15 percent to 29 percent.
Healthy timing and spacing of pregnancies, alongside an increase in births taking place in Health Centers with skilled care during delivery and postpartum care, offers a strikingly successful model to reduce maternal mortality and improve child survival.
In addition to expanding access to voluntary family planning information and services, Melinda Gates, co-chair of the Bill & Melinda Gates Foundation, has also focused on healthy timing and spacing of pregnancies as a critical factor for global health and development. Hope Through Healing Hands, with support from the Gates Foundation, is promoting awareness and advocacy among Americans to support maternal, newborn, and child health. We are highlighting the crucial role that voluntary family planning is playing in nations such as Ethiopia.
Healthy timing and spacing of pregnancies does more than save lives from health risks: it also allows girls to stay in school. In Ethiopia, where the average age of marriage is just sixteen (with many girls married as young as age eleven), girls are often forced to drop out of secondary school to begin families. If girls can delay their first pregnancy and stay in school, ideally until the university level, they will be better equipped to partner with their husbands to meet their children's needs, in a more stable family economic environment.
And as First Lady Roman Tesfaye of Ethiopia stated, "When a mother can contribute to her own life and family, she contributes to the nation as a whole." Moving beyond the national level, healthy timing and spacing of pregnancies is also a key to other global health goals, like combating hunger and improving the status of women and girls. Family planning is a key, often hidden, engine for additional global health achievements.
Family Planning 2020 is a global partnership of more than 20 governments working with civil society, multilateral organizations, the private sector and others. Created at a 2012 London summit, it represents a commitment to meet the needs of an additional 120 million women who want to delay or prevent pregnancy but lack access to information and tools.
With a focus on healthy timing and spacing of pregnancies, we can make major strides in just a few years. That's great news for mothers, children, and our entire world.CHAPTER 3
Family Planning as a Pro-Life Cause
Visitors walking through the thatched houses of this village on the shore of Lake Kivu are shadowed by a large, happy rabble of young children. There are, however, few middle-aged women in evidence—perhaps not surprising in a country where a woman's average life expectancy is forty-nine.
After I talked to women in Bweremana, the correlation between the number of children and the absence of some of their mothers became clear. Kanyere Sabasaba, thirty-five, has had ten children, eight of whom have survived. Her last delivery did not go well. "I delivered the baby without any problem, but I was bleeding much," she told me. The case was too complex for the local health center, so Kanyere had to pay for her transport to another medical facility. After the surgery, the doctor performed a tubal ligation. "If I give birth again, I could die," she said. "The last child is the one who could really kill me."
In this part of Congo, the complications of childbirth are as dangerous as the militias in the countryside. One woman I met had given birth to thirteen children, only six of whom survived. Women sometimes deliver in the fields while working. Medical help can be a few days' journey away. Each birth raises the odds of a hemorrhage, infection, or rupture. Those odds increase dramatically when births come early in life, or late in life, or in rapid succession. In Congo, almost one in five deaths of women during childbearing years is due to maternal causes.
The women of Bweremana are attempting to diffuse and minimize their risk. In a program organized by Heal Africa, about 6,000 contribute the equivalent of 20 cents each Sunday to a common fund. When it is their time to give birth, the fund becomes a loan to pay transportation and hospital fees. The women tend a common vegetable garden to help with income and nutrition. And the group encourages family planning.
The very words "family planning" light up the limbic centers of American politics. From a distance, it seems like a culture war showdown. Close up, in places such as Bweremana, family planning is undeniably pro-life. When births are spaced more than twenty-four months apart, both mothers and children are dramatically more likely to survive. Family planning results not only in fewer births, but in fewer at-risk births, including those early and late in a woman's fertility. When contraceptive prevalence is low, about 70 percent of all births involve serious risk. When prevalence is high, the figure is 35 percent.
Support for contraception does not imply or require support for abortion. Even in the most stringent Catholic teaching, the prevention of conception is not the moral equivalent of ending a life. And conservative Protestants have little standing to object to contraception, given the fact that they make liberal use of it. According to a 2009 Gallup poll, more than 90 percent of American evangelicals believe that hormonal and barrier methods of contraception are morally acceptable for adults. Children are gifts from God, but this does not require the collection of as many gifts as biologically possible.
Yet the role of contraception in development has become controversial—and both ideological extremes seem complicit in this polarization. Some liberal advocates of family planning believe that it is inseparable from abortion rights—while some conservative opponents of family planning believe exactly the same thing, leading them to distrust the entire enterprise. Suspicions on the right are not allayed when the vice president of the United States seems tolerant of forced abortion in China.
But women in Congo have enough home-grown problems without importing irrelevant, Western controversies. While both the pill and condoms are generally available in larger cities such as Goma, access is limited in rural districts. Determining the pace of reproduction is often a male prerogative instead of a shared decision. Sexual violence can be as close for a woman as gathering fuel in the woods.
Contraceptives do not solve every problem. But women in Bweremana want access to voluntary family planning for the same reasons as women elsewhere: to avoid high-risk pregnancies, to deliver healthy children, and to better care for the children they have. And this is a pro-life cause.
Excerpted from The Mother and Child Project by Jenny Eaton Dyer. Copyright © 2015 Zondervan. Excerpted by permission of ZONDERVAN.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
ContentsForeword Choosing Joy for Mothers and Children, Kay Warren, 13,
Preface All Lives Have Equal Value, Melinda Gates, 15,
Third World Woman, Amy Grant, 19,
Part 1: Maternal and Child Health: How Healthy Timing and Spacing of Pregnancy Saves Lives,
Mihret Gebrehiwot's Story: Ethiopia, 23,
1. A Mama Knows, Rachel Held Evans, 25,
2. Contraception Is a Pro-Life Cause in Developing World, Bill Frist and Jenny Eaton Dyer, 29,
3. Family Planning as a Pro-Life Cause, Michael Gerson, 33,
4. Transforming the World, David Stevens, 37,
5. The Burden We Should Share, Cathy R. Taylor, 45,
6. Baby Free Until 2013, James and Jena Lee Nardella, 47,
7. Women and Girls' Health, Phillip Nieburg, 51,
8. She Counts, Shannon Trilli, 55,
9. New Ideas, New Opinions, Victoria Jennings, 59,
10. Who Will Take Care of My Children? Elizabeth Styffe, 65,
11. A "Big Tent" Approach, Kent R. Hill, 69,
12. Personal and Professional Reasons to Be Thankful for Child Spacing, Ray Martin, 73,
13. Why Christians Should Care About Maternal Health, Shepherd and Anita Smith, 77,
14. Contraception Uncoupled, Joe McIlhaney, 81,
15. From Mother to Mother, Kimberly Williams-Paisley, 85,
Part 2: Strong Mothers: The Key to Healthy Families, Communities, and Nations,
Beryl Anyango's Story: Kenya, 93,
16. Helping Women Isn't Just a "Nice" Thing to Do, Hillary Clinton, 95,
17. Maternal Health and the Strategy for Empowering Women, Bruce Wilkinson, 105,
18. Better Moms Make a Better World, Sherry Surratt, 109,
19. Healthy Mothers Create Healthy Societies—and a Safer World, Kay Granger, 113,
20. How I Became a Maternal Health Advocate, Christy Turlington Burns, 115,
21. Family Planning and Linkages with US Health and Development Goals, Janet Fleischman, 117,
22. Making Dreams Come True, Jennifer Nettles, 127,
Part 3: Other Concerns: Male Involvement, Child Marriage, Slavery, and Orphan Care,
Namatta Lillian's Story: Uganda, 133,
Kiran Awasthi's Story: India, 135,
23. What's So Scary About Smart Girls? Nicholas Kristof, 137,
24. Men as Difference-Makers, James Nardella, 141,
25. From the Shade of an Acacia Tree, Dan Haseltine, 145,
26. Too Young to Wed, Cynthia Gorney, 149,
27. Child Marriage and Dowry Deaths, Jimmy Carter, 163,
28. A Promise to Girls, Desmond Tutu and Ela Bhatt, 169,
29. Forced to Confront the Impossible, Christine Caine, 173,
30. Brothels, Survival, and Hope, Natalie Grant, 177,
31. Contraceptives in the Developing World, Tony Campolo, 181,
32. Speaking Up for Other Mothers, Tracie Hamilton, 185,
33. Every Child Deserves a Family, Mary Beth Chapman, 189,
Part 4: Why Maternal Health Matters to People of Faith,
Dorine's Story: Burundi, 195,
34. The Good Samaritan in the Global Village, Jim Wallis, 199,
35. The First-Responder Church, Santiago "Jimmy" Mellado, 203,
36. You Just Never Know, Mike Glenn, 207,
37. Blessed for All Generations, Dan Scott, 209,
38. What Kind of People Ought You to Be? Jennie Allen, 213,
39. On Shame and Stewardship, Scott Sauls, 217,
40. Sovereign Over Us, Michael W. Smith, 223,
41. The Old New Thing, Sarah Masen and David Dark, 225,
42. The Village Nearby, Debbie Dortzbach, 229,
Appendix: What You Can Do,
1. How You Can Become an Advocate, 233,
2. How You Can Give: Partners in Maternal Health, 235,
About Hope Through Healing Hands, 239,