Preaching ‘Essential Obstetrics’

Dr. Robert Walley says improved health care in impoverished nations will consequently lead to a greater respect for life.

Governments and the United Nations regularly put forward “reproductive health programs” — euphemisms for abortion and birth control — as means of reducing the number of maternal deaths.

But Catholic obstetricians such as Dr. Robert Walley have long argued instead for “essential obstetrics” — an effective alternative of safe, hygienic and quality natal care. Walley, who founded Matercare, an organization of Catholic health professionals dedicated to the care of mothers and babies, spoke to the Register of his concerns while attending a Human Life International congress in Rome in October.

What is the current rate worldwide of women who die in childbirth or pregnancy?

The figures are shown to be less than what the U.N. and WHO [World Health Organization] have been saying. The reason for that is that the previous data on this wasn’t accurate but more based on “guesstimates.”

Now they’ve done this [recent] study, which was published in [the medical journal] The Lancet, of 181 countries, over 20 years or more I think, and it shows the number of deaths is a third less than thought, about 350,000, and it has reduced in those countries that have introduced essential obstetrics. The paper also mentions nothing about abortion as being important in reducing maternal mortality.

[The research, published in The Lancet in April 2010, found that the number of women worldwide who die in pregnancy or childbirth fell by more than 35% between 1980 and 2008 to 343,000 a year. The findings contradict those of a separate World Health Organization-led study which says the annual figure has remained steady at between 350,000 and 500,000 deaths. Dr. Richard Horton, the journal’s editor, disclosed that several maternal health organizations had asked him to delay publishing the figures until after a series of fundraising meetings.]

And yet the argument on maternal mortality is that it’s used by many governments, especially at the U.N., to push through reproductive rights, abortion and birth control?

Absolutely, and this paper in The Lancet proved them wrong. What they tried to do was to pressure the editor of The Lancet to suppress the article. … It’s outrageous.

You mentioned in your speech a need for a Marshall Plan to help Catholic health-care NGOs (non-governmental organizations). Could you explain more what you mean by that?

Yes, people may have thought me totally naive and unrealistic, but I think the Church has to do something extraordinary. And it can only be done if it pulls all of its resources from all its service clubs — like the Knights of Columbus, the Knights of Malta.

All these agencies can do something that challenges the world and says: “We do care; it’s fundamental to us. It’s important, and we’re going to do this — put an emphasis on essential obstetrics.”

If you look around the world, whether it be North America, Ireland or Africa, it was the Church which did and still does provide health care. It is one of the largest providers of health care, but I don’t think the Catholic community knows it still is. If you go to Kenya, the bishops get nothing and yet they provide 40% of the medicine — yet they receive nothing from the government and nothing from the aid agencies.

Are Catholic advocacy groups putting this point across in Europe and America?

No, and we struggle simply because of what we’re about.

To put it crudely, when you talk about these issues, it’s the full-meal deal, as McDonald’s used to say. You can’t come into this area with a cafeteria approach. For sure, Catholic ob-gyns [obstetricians and gynecologists] will all agree with you about abortion, and will probably go along with the Church’s position on embryonic stem cells. But when it comes to Humanae Vitae and you ask if there is anything we could do better, anything that people want, then they walk away.

The main point I wanted to make in my speech was that the Church has failed to evangelize the medical profession — they’ve kind of let us sink or swim. And what has happened? We’re sinking, except maybe for the younger people who are coming in, who see what can be done with ultrasound, and they’re kind of questioning. They’re asking: “What have you been doing for all these years?” A million and a half abortions a year, and the question is: “Well, that’s a heck of a lot of abortions. Why isn’t there an alternative?” If you did a million and a half hysterectomies they’d be looking at you and saying, “Hang on a second. What’s the disease we’re treating here?”

Could you tell us more about what you’re proposing as an alternative to the tendency of governments to push for “reproductive rights”?

It has to be essential obstetrics where you provide prenatal care, a safe, clean place to deliver, a skilled person to look after you, and post-natal care.

And this has been shown to work?

Absolutely. The consensus among obstetricians is that it does work, and so that’s what we’re doing. If you go anywhere in the United States, they have safe, clean places, skilled people, and they have blood banks, transportation, and so on. So we at Matercare are trying to do that in Kenya. We did it in Nigeria; we improved it in Ghana, and now we’re doing it in a remote part of Kenya — to show that you can improve the health of the mother who’s on the periphery by taking the hospital to her.

Why do I know this? Because in England they started doing that in 1940. It was called the flying squad; ours is called Emergency Obstetric Transport.

What can the Church do to better provide this alternative?

Use its facilities in a new way. Especially the bishops’ conferences should be aware of what we’re saying and doing and what the study shows, and then getting the whole Church, as John Paul II said, to help — and that means funds. You can’t do it with just good intentions; you need money and strong advocacy. That is the layperson’s job: medically, nursing-wise and politically, we should be exerting pressure.

Do you see attitudes to this changing — this alternative getting more attention?

The U.N. will be hard-pressed not to provide essential obstetrics. The Canadian prime minister, when he was chairman of the G20, his policy for the whole of that year of his presidency was maternal mortality, essential obstetrics, nutrition and clean water and so on, but no abortion, no birth control.

He wobbled on birth control after pressure, and even some of his ministers tried to kind of edge him round to it, but he came out strongly again. The world did pay attention to what he was saying, but it was the other side who castigated him — [U.S. Secretary of State] Hillary Clinton castigated him.

The other point I want to make is that they’re always giving funds to the vast agencies, but the organizations that count are the NGOs. We don’t get any government funding — there’s no level playing field for faith-based initiatives.

Edward Pentin writes from Rome.