A/61/338 health/right/. For ease of reference, these documents, and selected conference papers, can also be found on the website of the Human Rights Centre, University of Essex, http://www2.essex.ac.uk/human_rights_centre/rth.shtm. II. Reducing maternal mortality: the contribution of the right to health 7. In 2000, the estimated number of maternal deaths worldwide was 529,000; 95 per cent of these deaths occurred in Africa and Asia.1 While women in developed countries have only a 1-in-2,800 chance of dying in childbirth — and a 1-in-8,700 chance in some countries — women in Africa have a 1-in-20 chance. In several countries the lifetime risk is greater than 1 in 10.2 Women living in poverty and in rural areas, and women belonging to ethnic minorities or indigenous populations, are among those particularly at risk.3 Complications from pregnancy and childbirth are the leading cause of death for women 15-19 years old in developing countries. Globally, around 80 per cent of maternal deaths are due to obstetric complications, mainly haemorrhage, sepsis, unsafe abortion, pre-eclampsia and eclampsia, and prolonged or obstructed labour.4 Complications of unsafe abortions account for 13 per cent of maternal deaths worldwide, and 19 per cent of maternal deaths in South America.5 An estimated 74 per cent of maternal deaths could be averted if all women had access to the interventions for addressing pregnancy and birth complications, in particular emergency obstetric care. 6 8. For every woman who dies from obstetric complications, approximately 30 more suffer injuries, infection and disabilities.7 In 1999, WHO estimated that over 2 million women living in developing countries remain untreated for obstetric fistula, a devastating injury of childbirth. 9. There is no single cause of death and disability for men between the ages of 15 and 44 that is close to the magnitude of maternal death and disability.8 10. These deeply shocking statistics and facts reveal chronic and entrenched health inequalities. First, the burden of maternal mortality is borne disproportionately by developing countries. Second, in many countries, marginalized women, such as women living in poverty and ethnic minority or indigenous women are more vulnerable to maternal mortality. Third, maternal mortality and morbidity rates reveal sharp discrepancies between men and women in their enjoyment of sexual and reproductive health rights. 11. An increasing number of countries have made progress in reducing maternal mortality. However, progress has stagnated or been reversed in many of the countries with the highest maternal mortality rates.9 This is despite longstanding international commitment and initiatives to reducing maternal mortality. 12. In recent years, there has been a deepening conceptual understanding of maternal mortality as a human rights issue. 10 In this chapter, the Special Rapporteur explores some of the facets of the relationship between maternal mortality and the right to the highest attainable standard of health. 06-51997 5