Too many moms dying

Amnesty International has called for child grants to be extended to pregnant women, saying that the death of 1 400 women in childbirth every year in this country is "simply unacceptable". Maternal death is frequently used as an indicator of the state of a country's health system.

South Africa has a higher maternal mortality rate than Equatorial Guinea, where the rate is 240 deaths per 100 000 births. The estimate for South Africa is 269 per 100 000. Amnesty International's report, "Struggle for Maternal Health: Barriers to Antenatal Care in South Africa", highlights the problems of rural women especially in accessing antenatal care , which is essential to detecting complications in pregnancy and ensuring that HIV-positive pregnant women are treated timeously with antiretroviral drugs.

The cost of transportation to a clinic hampers access to healthcare for rural women. Women and healthcare workers interviewed in rural Mpumalanga and northern KwaZulu-Natal said pregnant women believed that they would be compelled to undergo testing for HIV when they sought antenatal care. Women also said that if they tested positive they were segregated in queues and treatment rooms, revealing their HIV status. Healthcare workers said belief in myths about contraception, such as that condom use led to cancer, left many teenagers vulnerable to unplanned pregnancy. Amnesty International said the Department of Basic Education should provide advice about sex and family planning at schools. The rights group called for the Department of Transport to ensure that rural areas were accessible.

Rains and poor roads often prevented ambulances from reaching women in labour. Women reported having to pay R500, frequently borrowed, for a private car to take them to a hospital when they went into labour. With average household income at about R1 000, this expenditure would mean going without food. A grant linked to antenatal care would allow women to get to clinics and hospitals in time, said the secretary-general of Amnesty International, Salil Shetty. According to Shetty, South Africa was unlikely to meet its UN Millennium Development Goal of reducing maternal mortality to 38 women per 100 000 births by 2015. Department of Health spokes-man Joe Maila said the department had launched MOMconnect, a mobile-device app to provide pregnant women with information by text message.

Katharine Child: The Times, 10 October 2014