The rate of return is positive if it involves women’s health

Even if only from a purely utilitarian point of view, investing in improving women’s health not only improves their quality of life, but also enables them to participate more actively in the workforce, or in the case of postpartum, to return more effectively to the workforce. The potential value created by women’s increased productive participation would exceed the costs of implementation by a ratio of $3 to $1 globally. This estimate is based on the net annual costs associated with the additional interventions needed to close the women’s health gap; this figure was then compared with the additional economic potential that could result from the health improvements associated with these interventions.

(1)

Of course, the economic return varies by area; it is higher in higher-income settings and lower in lower-income countries, where more investment is needed for basic health infrastructure and to create better economic opportunities for women. Therefore, any concrete action to address the gap in women’s health and to aspire to better health equity must be calibrated to the specific socioeconomic conditions of each place.

There are several fronts on which to act to close the gap

Reference should be made to investments in women-focused research, sex- and gender-disaggregated data collection, improved access to women-specific care, to investments focused on innovation in women’s health and business policies that support women.

We must necessarily start with increasing knowledge and data on the specific conditions of women and the various diseases that affect them differently or disproportionately, with the help of technology that makes it easier to systematically collect and analyze sex-disaggregated data at every stage of the research and development process. One proposal to encourage the shift to disaggregated data is to consider sex as a biological variable. (2)

Even today, modern medicine is based on research conducted almost exclusively on male individuals, with consequences of overdose and side effects in prescriptions for women, misdiagnosis and delayed diagnosis, and ignorance of female anatomy. Suffice it to say that it was not until 1998 that it was discovered that the clitoris also consists of an internal structure. (3)

The late discovery of the structure of the clitoris can be considered precisely a case study of the invisibility of women’s issues in science and medicine.

Instead, with a new approach to data, companies in the industry can more accurately assess the safety and efficacy of their products in development by adjusting formulations and dosages.

In addition, women should be actively involved in research with decision-making and initiative roles; in fact, they seem to hold only 25 percent of the top roles, despite making up 70 percent of the global health and social workforce. (4)

This would also positively impact higher levels of reliability and efficiency for working groups with diverse gender representation. (5) Even on the level of medical patents, in a study that analyzed more than 440,000 patents filed from 1976 to 2010, it was found that inventions made by women were up to 35 percent more likely to make improvements in women’s health than discoveries made by men. (6)

Concerning access to care, healthcare providers should be able to ensure the same level of quality for women as for men and to do this, we would need to start again with medical curricula, residency courses, and continuing education institutions and organizations to update training on what biological differences based on sex are, recognize inherent disparities, and correct them. For example, healthcare systems could provide sex-specific cut-off values for biomarkers, and pharmaceutical companies could include sex-specific tests and results in package inserts, to also inform healthcare providers of what the best-dedicated treatments might be.

Need to improve access to specific services, from prevention to diagnosis and treatment

On the pregnancy side, there should be investment in the number, training and continuing education of midwives, who can make a difference in reducing maternal mortality globally to the point of preventing about two-thirds of maternal deaths. (7)

At present, more than 1,400 midwives seem to be missing in the Valencia Community alone, because the World Health Organization estimates that one midwife is needed for every 400 women of childbearing age. In Valencia we are talking about a total of more than 47,200 women between the ages of 15 and 44 and about 360 midwives, so according to WHO 1,400 midwives would be needed, more than 700 more than the current number. If one considers the entire Valencian Community, however, with the provinces of Alicante, Castellon and Valencia, the deficit rises to more than 1,400 midwives. (8)

Spain ranks among the countries with the lowest number of midwives in Europe, but the trend is global due to the unsatisfactory and compromised wage environment, difficult working conditions and barring to the training path.

The figure of the midwife plays a key role in the entire life cycle of women, from the first menstruation to menopause, not only during pregnancy, but at this time their importance even intensifies. Thus, we need to start by increasing the number of midwives who are trained annually to aspire to provide good health care based on the percentage of births and women who need care.

Midwives and doulas are some figures for practical, emotional and informational support of the pregnant woman

The incidence of another professional figure, the doula, generally a woman, trained to provide care, guidance, and support from an emotional standpoint to women during pregnancy, childbirth, and postpartum seems to be increasing. These professionals, unlike midwives, are not qualified to take care of birth; they do not possess the guarantees of a qualified healthcare provider, especially within a hospital facility.

Their intervention, which can begin as early as the first months of pregnancy, however, is linked to better birth outcomes, with fewer C-sections, fewer premature deliveries, shorter duration of labor, and improved breastfeeding. In addition, from an emotional point of view, the support a doula offers has positive repercussions on a woman’s anxiety and stress, precisely because she is perceived as someone present, who makes her feel safe and comfortable, and with whom a trusting relationship has been built, even if outside the medical field. (9)

We must come together to address and resolve the social, political and economic issues that are shaping our world. We must speak out and act decisively to illuminate and overcome the challenges that are at the root of our struggle and engagement. Together, we can build a more fair and inclusive society, where every woman has the strength and resources to overcome any barrier.

We believe in a collaborative and personalized approach to ensure the best experience for the woman and support her whatever her choices are, before, during and after delivery. We believe in the need to integrate the psycho-social dimension of women into the processes of care, listening carefully to their needs so that they feel stronger and safer from start to finish.

Motherhood and childbirth cannot only be regarded as medical experiences, rather they are social experiences, that women badly need.