Enhancing the Reproductive Justice Framework to Improve Maternal and Neonatal Outcomes through Reproductive Health Promotion: Global Lessons from an Ethiopian Case

Abstract: Pregnancy-related complications contribute to elevated neonatal and maternal mortality in both low-middle-income countries and high-income countries. Barriers to care prohibit timely medical interventions that can be lifesaving.

In this session, we will argue that safety for the pregnant patient and her unborn child throughout the pregnancy should be a fundamental component of the “right to have children” from the Reproductive Justice Framework (RJF). In the US and many countries, sex education emphasizes contraception to avoid infections unwanted pregnancies, aligning with the RJF right “not to have children.” However, this education currently fails to encompass signs that warrant medical attention during pregnancy. Pregnancy-related physiology and health conditions are often dismissed as “women’s issues.” They should, however, be viewed as a general healthcare issue, as they affect the pregnant patient and her offspring, partner, family, and community. Comprehensive health education can encourage patients to seek care before they or their unborn child becomes imperiled. Additionally, barriers to antenatal care access may arise from various sources, ranging from environmental injustices like poor road infrastructure and scarcity of healthcare clinics to social injustices like lack of insurance, prohibitive costs, and poor trust in the healthcare system.

Using an example case from Ethiopia, as sub-Saharan Africa shoulders the largest neonatal and maternal mortality burden, we will propose expanding the RJF to address these and other gaps. We will also engage the audience around actionable recommendations for bedside clinicians, public health professionals, and governmental and non-governmental organizations globally and domestically to improve neonatal and maternal outcomes.

Betty Kassa – Department of Pediatrics – College of Health Science, Addis Ababa University; Stephanie Kukora – (1) Bioethics Center and Division of Neonatology; (2) Department of Pediatrics – (1) Children's Mercy Kansas City; (2) , University of Missouri – Kansas City; Cheryl Moyer – Department of Obstetrics and Gynecology – University of Michigan