The University of Washington estimated there were 342,900 maternal deaths worldwide in 2008 and more than half of all maternal deaths were in only six countries in 2008 - India, Pakistan, Nigeria, Afghanistan, Ethiopia, and the Democratic Republic of the Congo. Our maternal mortality rate at Kijabe is lower than the national average, but in reality the data is scarce as most women still deliver at home with unskilled birth attendants.
We see between 60-80 women in GYN clinic each week and one of the most common chief complaints is infertility. What is the best help I can provide knowing childbirth is relatively unsafe? Women are far more likely to die giving birth then from infertility. Yet, these women will also be abandoned. Azia serves as good example. Married at 16 by arrangement in Somalia, she did not produce a child, so her husband took another wife and then finally divorced her at age 28. Her family promptly repeated the genital mutilation and returned her for her brothers to care for. Today she came for help. She wanted to know if she could have a surgery that would help her fertility so that she would be eligible again for marriage.
When she learned that I thought a myomectomy and tuboplasty would help her, she profusely kissed and hugged me. Her entire societal value depends on her ability to conceive. And when that is gone so is her hope and her future. It's not just that she wants to have a child, it's that she has to bear a child to have any value in society.