Maternal mortality rates have declined significantly in recent decades, but could be reduced further if policymakers ensure decent maternal healthcare all over the EU, says Mariya Gabriel.
Mariya Gabriel is a Bulgarian member of the European Parliament, representing the European People’s Party (EPP). She answered questions by EURACTIV’s Henriette Jacobsen during the Safe Motherhood Week (28 September-4 October).
Why did you decide to become involved in this health-related topic?
As President of EPP Women, much of my time and efforts have been devoted to promoting greater gender equality and to increasing awareness about the importance of women’s empowerment. In 2013, I received the MEP Award in the category Gender Equality, and in 2015 the EACA Care Award for my commitment to violence against women and to gender equality. I am currently the rapporteur for the so-called Women on Boards Directive, which aims at breaking the glass ceiling and increasing the gender diversity of corporate boards.
Equality between men and women is a cause that is very close to my heart and to which I have dedicated my work as a politician but also as a woman.
Gender-based inequalities are also present in healthcare and women and men are confronted with gender-specific health risks which need to be adequately addressed. We still have wide variations and disparities across member states as regards health rights, and more specifically, maternal rights. Narrowing these gaps is critical to achieve women’s empowerment and gender equality.
Which EU countries in particular face the biggest challenges with maternal mortality?
Maternal mortality rates have declined significantly in the last decades, to seven deaths per 100,000 women in average. But still many of these deaths could be avoidable. Despite the improvement of maternal care over the last decades, there are still wide variations across member states as regards maternal mortality, which is considered as an indicator of the quality of obstetric care in a country.
These variations are mainly due to differences in terms of access to high quality care, which includes access to ultrasound scanning, to regular screening for foetal abnormalities and to trained healthcare providers. In that sense, we should aim at narrowing the existing health gap and to further reduce these variations.
I believe there is still room for improvements in terms of maternal healthcare in the EU and it should remain an important issue for member states. It is very essential to keep in mind that maternal health is determinant for new-born health and development and thus, for the general health of European citizens.
How aware are policymakers of this health problem?
We all agree that the principles of universality, access to good quality care, and equity in EU healthcare systems should underpin our action in this field.
Health remains a member state competency and the EU provides support and coordinates the actions of the different member states, but we should pursue our efforts to raise awareness, to gradually shift the debate on maternal health to the European level and give it a new impetus. The EU is an excellent chance for the exchange of best practices and we should seize this opportunity.
Is the problem of maternal mortality more related to women having to give birth on their own, rather than doctors and clinics doing a bad job assisting the women?
I believe there are different factors, which all need to be tackled. On one hand, there are nowadays different factors such as longer studies, or a greater involvement in paid employment, which lead to women in Europe having children later in life.
These new trends create different types of health risks and needs, which have to be addressed. On the other hand, there are significant intercountry but also intracountry variations, due to differences in terms of health infrastructure, availability of qualified staff or, simply, the information which is made available. In that sense, the collection of data, and the conduct of benchmarking analyses across member states, remain an efficient tool to reflect on the causes of maternal mortality and the possible solutions.
Since it’s often migrant mothers who suffer, is the issue not more related to the EU’s failed migration policies rather than the health systems not doing a good job?
The issue should be addressed horizontally across sectors and policies. In the European Union, maternal and child health entitlements that migrants and refugees may benefit from are decided at national level by member states, which differ greatly in the degree and type of healthcare they provide to pregnant migrants.
Besides these variations, there are also practical obstacles and challenges which hinder the access of female migrants to healthcare such as the lack of information on their health rights. It is thus important to persevere in our efforts to integrate a gender perspective in our migration policy so that all EU member states are able to meet the needs of particularly at-risk groups such as women migrants and refugees, because we should not forget that migrant mothers are three times vulnerable.
What is your solution to the problem?
I truly believe that the answer will necessarily be a cross-cutting and comprehensive one, and should involve a wide array of actors, ranging from national and European policy-makers to health professionals and organisations of the civil society.
Europe can become a platform for the exchange of good practices in this field, by encouraging cross national trainings and the establishment of networks of health professionals. The conduct of benchmarking analyses across member states and the development of common indicators could allow us to identify the problems and reflect on the possible solutions and the way forward.
The event we hosted at the European Parliament is a first step to raise awareness on the importance to ensure decent maternal healthcare all over the EU, as part of our broader strategy to promote women’s empowerment. But we should also keep in mind that maternal health care and child health are a key element to increase the general health in Europe, and thus in the long term, a mean to ensure the economic development and prosperity of the EU as a whole.