U-M Dr. joins world’s top maternal health researchers for Lancet Series

Despite advancements in recent years, giving birth remains a dangerous proposition for too many mothers in too many places. That’s according to a new global maternal health series published in The Lancet by an international group of leading experts in the field, including one U-M researcher.

Assistant Professor of Learning Health Sciences and Obstetrics and Gynecology Cheryl Moyer, MPH, PhD, is a co-author who helped produce The Lancet’s comprehensive Maternal Health 2016 issue, published last month. A follow-up to a similar 2006 Lancet series, the six new papers take stock of a decade’s worth of progress and shortcomings in maternal health. Among the vital takeaways: while maternal deaths globally have fallen by more than 40 percent since 1990, the disparity between those areas and those populations with the highest and lowest mortality rates has increased exponentially during that time.

“The report makes it clear that, while we’ve made progress, there remain enormous gaps and disparities no matter where you are,” Moyer said. “It doesn’t matter if you’re here in the U.S. or you’re in Africa.”

In sub-Saharan Africa, according to the report, a woman’s risk of dying in childbirth is a startling 1 in 36, compared to 1 in 4,900 in high-income countries like the United States. Yet at the same time, in 2010, African American women in New York City were more likely to die in childbirth than were women in either North Korea or Vietnam. While services in many areas remain underdeveloped, the report also includes cautionary tales about excessive services in other settings, driving up unnecessary cost and sometimes increasing health risks as well.

Over nearly 100 pages across six entries, the series offers a comprehensive snapshot of global maternal health trends past, present and future. It includes warnings about perils to avoid (under-preparing for the impacts of natural disasters, illness outbreaks, and climate change, for example). It concludes with aggressive goals and recommendations for achieving the WHO’s global Sustainable Development Goal (SDG), which aims to lower worldwide maternity mortality ratios to less than 70 deaths per 100,000 births by the year 2030.

“The challenge was first to assemble what amounted to a laundry list of things to address, and then to single out the items that are the most critical,” said Dr. Moyer, who has done extensive research to improve maternal health access in Ghana over the last decade. “But doing that is difficult because maternal health is such a complex issue. It involves education, family planning, access to care, infrastructure, training more professionals ... the list goes on.”

Dr. Cheryl Moyer, MPH, PhD

The project took nearly two years to complete and included experts from the London School of Hygiene and Tropical Medicine, Harvard University, the University of Washington, and more, as well as perspectives from organizations like USAID and the WHO. Economists, human resources experts, clinicians and researchers all offered insights and perspectives. Dr. Moyer is listed as a co-author on two of the papers, including the final piece offering recommendations and target goals.

“I was honored to be asked to participate,” she said. “These are the global leaders in the field, so I found myself working alongside the very people whose papers I’ve been referencing all these years. That was cool.”

Since its publication on Sept. 15, the series has already garnered widespread media attention, making headlines in the Toronto Star, The Guardian, Huffington Post, and more.

“We certainly want to keep the conversation going around maternal health, because conversations become a catalyst for change,” Dr. Moyer said. “The idea is to get academic researchers, program implementers, policy makers and government representatives talking to one another about the best way forward.”