Mr. Speaker, I rise to speak on this issue because, having been a member of Parliament in this place for 17 years, I have still not lost my roots, which are in medicine. I have delivered 800 babies during the course of my time as a family physician.
This issue is of extreme importance to me. When I look at my own country of Canada, I realize that one in 11,000 women die in childbirth here. In the developing world, one in three women die in childbirth. There is an enormous number of stillborn children. There are many children who are born and, within 42 days, fail to thrive and actually die.
A country like Canada professes to care. This is at the root of the decision to sign on to the millennium goals for 2015. We do care about others. First and foremost, we do not apply quality of care to other countries or to developing nations that is less than what we would give to our own people. Being a physician and accepting that we cannot be second best for the people of the developing world, I think we have to consider that this motion speaks exactly to this issue.
The concepts behind millennium goals four, five, and to some extent six, are all about maternal and infant health. It is about preventing the toll of extraordinary death. I just want to cover a couple of facts quickly. Every minute of every day, a woman dies from pregnancy-related complications. That is more than half a million women each year and 99% of those deaths in pregnancy and childbirth occur in the sub-Saharan region.
Almost half of all women in developing countries deliver their babies without a nurse, midwife or doctor present. We know that that has to do with pregnancy itself. However, for those of us who have delivered babies and studied this issue of obstetrics all of our lives, we know that mortality and morbidity, meaning the illness accompanying it, does not begin the day a woman becomes pregnant. It begins when the woman is in her childbearing years.
Let us look at the millennium goals. They are pretty clear. In 2000, they were developed by 189 countries, some of them developed and some of them from the developing world. All of these countries came together and decided that, by 2015, they would look at a set of measurable and concrete goals, specifically under millennium goals four and five, to decrease maternity-related deaths, perinatal deaths and infant deaths.
In fact, that commitment was made and sworn to by all of the countries attending. Canada was one of them. They swore that they would uphold and commit to those goals and to the action plan for getting there. This is not an action plan that was drawn up out of somebody's head because it sounded good. This was based on good practice. This was based on knowledge of evidence-based medicine. This was based on knowing what contributes to maternal mortality and to child death. Therefore, it looked at clear guidelines that were based on knowledge, evidence and scientific information.
One of the first pieces of the concrete, measurable goals was that, by 2015, 58 million couples will have access to contraception and family planning. That was one of the goals. It was a clear and measurable goal. This is not rocket science. If a woman has many pregnancies and they are spaced less than two years apart, the ability for that woman to remain healthy and the ability for that woman's nutritional status and body to be able to carry pregnancies is immediately compromised by that frequency.
Here in Canada, I myself used to have one or two patients who would want to coalesce their births all in about three years. They wanted to have all their kids as quickly as possible. I would have to tell them that, if they wanted to have children under two years between the last one or under a year and a half between the last one, given that women's health status here is a lot better than in the developing world, it would create a higher level of risk for them during childbirth and for the child itself.
We know this here. It also applies to women in sub-Saharan Africa and the rest of the developing world. Women are not different anywhere in the world. The same physiological and pathophysiological processes apply everywhere regarding the issue of giving birth to children.
The House will please forgive me for being a little graphic here but when the uterus does not have time to go back to its old strength, to the thickness of its walls, it is very easy for it to rupture and for post-partum hemorrhage to occur, which is the major cause of death in childbirth.
We cannot separate the concept of family planning, of planning the number of children, of planning the distance between each child, which has an impact on the actual occurrence during pregnancy and childbirth for that maternal death and fetal morbidity to mortality occur. As I said before, this is not rocket science. It is very clear. We know this for a fact and this is what we need to apply.
I am concerned as a physician and, of course, as a member of Parliament to note that the concept of family planning and contraception, two of the key measurable millennium goals of goals four and five, are considered to be options. I think the Prime Minister said that he would keep those options open and not close any doors. This is tantamount to saying that he does not buy the knowledge gained over medical care for centuries, that he does not buy the fact that these two are linked and that he will consider whether his government will do this or not.
We need to base everything we do on evidence-based care, on knowing what the outcomes will be and knowing how to prevent those outcomes. If we do not, then we are doing quackery on people in other countries and treating them less than our own people.
We cannot say that we will consider the options. We need to say that these are clear guidelines set out by the goals and a concrete action plan that we are committed to following. We cannot cherry-pick it.
I would not be so bold as to say that this is ideological but I would be so bold as to say that this is not good medical care, nor is it good medical practice. This puts the lives of women at risk. We know what many women in the developing world need to resort to. We know that 20 million women each year have unsafe abortions and that 70,000 of them die from unsafe abortions.
Good family planning and good contraception is the most important step in preventing abortion. One of the key goals of the 2015 millennium goals is to halve the number of abortions in the world, and that is an extraordinarily important priority. This is not about morality. This is about preventing something that most of us do not want to see used as a method of birth control.
Those are important things that we need to talk about. We need to understand the medicine of this and the clinical practice that we are embarking on here.
Every year, 500,000 women die from pregnancy-related diseases. I listened to the minister responsible for CIDA say that the government was only interested in preventing deaths and therefore was only focusing on the pregnancy and the few days post-pregnancy when most women die. It is a fact that most women die at that particular time.
However, to suggest that the cause of post-partum hemorrhage and all the reasons for maternal death only occur during pregnancy is like suggesting that we decided to decrease the number of deaths from heart disease and that we will only focus on that during open heart surgery. It is like suggesting that prior to heart disease we do not care about obesity, smoking or trans fats. However, we do care about those things. We have debated in the House the issues of obesity, trans fats and smoking and we know those things contribute to cardiac disease.
There is a whole spectrum of things that we must do for the sake of women around the world who leave orphaned children when they die and for the sake of children who grow up with HIV-AIDS or hepatitis C. I will not elaborate on that because my colleague just spoke to the issue of sexually transmitted diseases and the fact that they cause chronic morbidity and maternal death.
I ask the government to please consider following the course that is already set based on good clinical guidelines.