In some countries, childbirth is not only a source of happiness and anticipation but also the most natural reproductive right amongst women. People celebrate pregnancies because they are key to pro-creation or continuation of human existence.

While in developed nations when women are pregnant, most of them are sure of delivering healthy babies, the story is different in developing countries like here in Malawi. The vernacular name of pregnancy, pakati, which could insinuate that a pregnant woman's life is hanging between life and death paints the already gloomy picture of our high mortality rate.

With maternal mortality rate pegged at around 675 deaths per 100,000 per live births, who can dispute that being pregnant in Malawi becomes a source of worry amongst some women. Political will on safe motherhood initiatives currently exist, but the death of 675 pregnant women per 100,000 who have given live births due to pregnancy-related complications is scary and unacceptable.

While developed nations have decisively dealt with causes of maternal deaths, authorities and health institutions in developing nations are struggling to arrest the problem. Despite efforts to reduce maternal mortality by providing antenatal care, emergency obstetric care and skilled attendance at delivery, the risk of dying during pregnancy or childbirth remains significant for our women.

The leading causes of maternal deaths are well-known. They include post-partum haemorrhage or bleeding, hypertensive disorders, sepsis, obstructed labour, and complications from unsafe abortions.

The question is: Why are countries like Malawi failing to address the problem of high maternal deaths whose causes are known? The reasons are many.

We are in a situation where due to lack of adequate health facilities, many births are assisted by traditional birth attendants (TBAs), who acquire their skills through experience and apprenticeship, rather than through the formal training that characterises health workers such as doctors, midwives, and nurses. When complications occur during the delivery process, TBAs struggle as they lack expertise and even medical services to which to refer women with major complications. Some complications at TBAs end up in deaths.

Malawi can solve the challenge of high maternal mortality by working towards the goal of having every birth attended by a skilled health personnel, be it a doctor, midwife, or nurse.

While health access to safe abortion remains the neglected taboo in discussions about safe motherhood, reproductive health and family planning, the challenge needs a solution. Much as the maternal mortality overall has slightly declined, women's deaths from unsafe abortions is still a public health threat. Without access to legal and safe abortions, many women will continue to die needlessly.

The death of expectant women is a tragedy which should be prevented at all cost. It is against this background that we request Global Leaders Council for Reproductive Health (GLC) and government officials, currently meeting in Malawi, to focus their discussions on issues of substance that can really arrest the challenge of high maternal mortality rate in the country.