A third of all health issues affecting women in their reproductive years (aged 15–44) are related to reproduction and sexuality, which affect women differently than men. Unsafe sex is a significant risk factor for these issues, particularly in developing nations.
A wide range of issues falls under the category of reproductive health, including the well-being and proper operation of the organs and systems involved in conception, pregnancy, delivery, and childrearing, as well as antenatal and perinatal care. Compared to developed countries alone, the focus on global women’s health is significantly more on reproductive health, as well as non-communicable diseases like malaria in pregnancy and infectious diseases (NCD).
Many of the issues that affect women and girls in areas with few resources, like female genital cutting and lack of access to the right diagnostic and clinical tools, are largely unknown in developed nations.
Even in developed nations and despite advancements in obstetrical science and practice, pregnancy still carries significant health risks. Maternal mortality is still a significant global health issue and is used as a sentinel event to assess the effectiveness of healthcare systems. Whether it is intentional or unintentional, and whether it occurs within a marriage or union or not, adolescent pregnancy poses a particular problem.
Pregnancy causes significant physical, emotional, social, and economic changes in a woman’s life and jeopardises her transition into adulthood. Most frequently, adolescent pregnancies result from a girl’s lack of options or abuse. Since 90 per cent of births to girls between the ages of 15 and 19 take place within marriages, child marriage is a significant global contributor.
The number of women worldwide who died in 2013 from pregnancy-related causes was about 289,000 (800 per day), with significant differences between developed and developing nations. In western countries, maternal mortality has been steadily declining, and it is the focus of yearly reports and reviews. However, the Maternal Mortality Ratio shows that between 1987 and 2011, maternal mortality in the United States increased from 7.2 to 17.8 deaths per 100,000 live births (MMR).
The rest of the world, however, reports rates as high as 1,000 per birth, with Sub-Saharan Africa and South Asia having the highest rates (accounting for 86 per cent of such deaths). Even though these deaths are rarely looked into, the World Health Organization believes that 99 per cent of them—the majority of which take place within 24 hours of childbirth—could be avoided with the right support systems, programmes, and facilities.
Maternal health suffers in these resource-poor nations due to poverty and unfavourable economic conditions that affect the infrastructure, medical facilities, equipment, and supplies, as well as the shortage of skilled workers. Other issues include the ability to recognise medical emergencies as well as cultural perspectives on sexuality, contraception, child marriage, and home birth.
These maternal deaths are directly caused by haemorrhage, eclampsia, obstructed labour, sepsis, and unsafe abortion. Additionally, AIDS and malaria make pregnancy more challenging. The leading cause of death from 2003 to 2009 was haemorrhage, which was responsible for 27% of fatalities in developing nations and 16% in developed nations.
Complications of pregnancy
Pregnancy can cause several non-fatal health issues in addition to deaths during pregnancy and childbirth, such as obstetrical fistulae, ectopic pregnancies, preterm labour, gestational diabetes, hyperemesis gravidarum, hypertensive conditions such as preeclampsia, and anaemia.
Pregnancy-related illnesses account for an estimated 9.5 million cases of illness worldwide, while 1.4 million near-death experiences are estimated (survival from severe life-threatening complications). Pregnancy complications can be social, economic, mental, and physical. According to estimates, 10–20 million women will experience physical or mental disabilities each year as a result of pregnancy-related complications or poor care. As a result, global organisations have created obstetric care standards.
Women’s sexual health
A woman’s autonomy and well-being depend on her ability to decide whether and when to get pregnant. Contraception can safeguard young girls and women from the risks of early pregnancy and older women from the higher risks of unintended pregnancy.
Achieving adequate access to contraception can lower maternal and infant mortality and morbidity, reduce the need for potentially dangerous abortions and restrict multiple pregnancies. Some barrier methods of contraception, like condoms, lower the risk of contracting STIs and HIV. Access to contraception empowers women, increases their ability to make decisions about their sexual and reproductive health, and improves their options for employment, education, and civic engagement.
Access to contraception plays a critical role in society’s efforts to control population growth, which has implications for the economy, the environment, and regional growth. Because of this, the United Nations views access to contraception as a fundamental human right that is essential to women’s empowerment, gender equality, and the reduction of poverty. Additionally, birth control is one of the top ten public health innovations of the 20th century.
Compared to spontaneous termination, abortion is the deliberate end of a pregnancy (miscarriage). In terms of women’s control and regulation of their reproduction, abortion and contraception are closely related, and both are frequently subject to similar cultural, religious, legal, and economic restrictions. Women turn to abortion in situations where access to contraception is restricted.
As a result, the number of abortions can be used to calculate the unmet need for contraception. However, women have always faced significant risks from available procedures, and this is still true today in developing nations or in places where legal restrictions force women to use covert facilities. Lower socioeconomic groups and those living in places where there are significant barriers to accessing safe, legal abortion place undue burdens on this right.
These issues have frequently been the focus of feminist and political campaigns, where opposing points of view contrast morality and health.
Sexually transmitted infections
Female genital cutting and sexually transmitted infections (STIs) are two significant issues for women’s sexual health (FGC). STIs are a top priority for global health because they seriously harm pregnant women and newborns. Stillbirths, neonatal deaths, low birth weight, prematurity, sepsis, pneumonia, neonatal conjunctivitis, and congenital deformities can all result from mother-to-child transmission of STIs. Every year, syphilis in pregnancy causes over 300,000 foetal and neonatal deaths as well as an increased risk of congenital illness, prematurity, and death in 215,000 infants.
For women in their reproductive years, menstrual cycles, the roughly monthly cycle of changes in the reproductive system, can present significant challenges (the early teens to about 50 years of age). These include physiological changes that can have an impact on one’s physical and mental well-being, ovulation signs, and the regular loss of the endometrium, which is accompanied by vaginal bleeding (menses or menstruation). Menarche, the beginning of menstruation, can alarm unprepared girls and be mistaken for illness. Women who are menstruating may experience undue restrictions on their participation in activities and access to menstrual products like tampons and sanitary pads.
This is especially severe among lower socioeconomic groups where they may be a financial burden and in developing nations where menstruation can prevent a girl from attending school.