As this academic year comes to a close, so does my two-year tenure as the Duke Global Health Institute Doctoral Scholar working with the Center for Global Reproductive Health. I have been so fortunate to be mentored by Dr. Huchko and the staff both here in Durham and in Kisumu. A true highlight has been collaborating with community partners as well as undergrads and grad students here at Duke. Pei-Yu Wei, another PhD student and I started a project investigating the impact of economic sanctions on women’s rights and maternal mortality, which we recently had the opportunity to present at a national conference and two academic workshops.
Economic sanctions are policy instruments used to influence the behavior of another international actor. While generally a less harmful method for countries to settle disputes compared to military force, sanctions still have the ability to adversely affect the civilian population in the targeted state. Much research has been done on the negative consequences of economic sanctions, from increasing inequality to shortened life expectancies for the citizens of the targeted countries.
But there is little research on how economic sanctions impact women. Since medical solutions to pregnancy-related deaths are well known, maternal mortality ratio (number of pregnancy related deaths per 100,000 live births) is a reliable indicator for a woman’s ability to access health care. Maternal mortality ratio (MMR) rises as women face barriers to health care services and lowers as they can visit health clinics and/or providers.
We hypothesized that our OLS regression analyses would reveal an increase in maternal mortality ratio when economic sanctions are present. Since economic sanctions affect the target country’s ability to procure necessary supplies, we hypothesized that MMR can be affected in the following ways: 1. contraceptives may become harder to obtain. This leads to unwanted pregnancies, which could result in unsafe abortions or more women forced to carry high-risk pregnancies to term, jeopardizing maternal health. 2. Women who may still be able to access hospitals and clinics may face longer wait times or find that their providers have less availability for pregnant patients as they are busier with increases in disease and malnutrition from the general population that accompany economic sanctions.
Our observational study using data on economic sanctions and MMR for the years 2000-2017, found that the presence of sanctions increases MMR in the target country by 13.45 per 1000,000 live births in the following year. This relationship was statistically significant at the p< 0.01 level when controlling for other factors in the target country such as GDP, conflict, trade openness, political capacity, and regime type. As economic sanctions have become more widely used by countries it is imperative for policy makers in sanctioning governments to understand the effects that their choices have on women’s health in the targeted states.