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The Cairo ICPD in 1994 considerably expanded and improved the status and health protection among women. This change is characterized by certain pros and cons in regards to limited financial and logistic resources, especially in some regions of sub-Saharan Africa where HIV/AIDS problems remain to be urgent. On the one hand, this conference helped to explain that smaller families can have more economic benefits and work opportunities, and women can meet their practical and strategic needs. On the other hand, women can become vulnerable and suffer from violence at home. Women from low-income regions have to cope with multiple family and work responsibilities and lose the security that is a part of their traditions.
The role of family planning in regards to the risks of maternal mortality remains to be limited, and this statement can be easily explained. First, the only aspect that family planning can change is the numbers. As soon as families are under control, and their sexual activity does not lead to unexpected pregnancies, the level of maternal mortality is not that dramatic. Second, the case studies and stats show that usually women from low- or middle-income families have a high level of dying. Finally, only first pregnancies may have a high risk of maternal mortality. Family planning may be implemented to the families with or without children; therefore, the role of this issue is limited. A woman can die during pregnancy or soon after giving birth to a child being a participant in a family planning program or not.
Specific technologies in the sphere of health may improve the situation of current reproductive health; still, these changes are not as sufficient as people may think. The changes in womens status within the reproductive health aspect are evident indeed: womens empowerment, multiple choices, the abilities to control a situation, and speak free. The health technological inputs can provide more changes, but the essence of the changes cannot be too much influential because of the inability to use appropriate technologies. Women have access to various means of contraception, still, the examples of maternal mortality or other problems with health or unexpected pregnancies show that the problem is not solved and has to be properly discussed.
Renewed interest in family planning and reproductive health can be explained in a number of ways. Women are in need of protection and explanations of their rights and abilities. The world is changing as well as the conditions under which women have to live. The changes of women rights may lead to some changes in family planning, and these changes have to be analyzed and discussed. Reproductive health is the problem that has not been solved completed during the last several decades. People still want to know more how to improve the reproductive health conditions and understand their options. Therefore, all these needs and expectations raise renewed interest in all these issues.
Obstetric fistula is not only a physical problem. The consequences of this problem may be of a social or physiological character. As a rule, women with obstetric fistula are socially isolated and feel shame because of their problems with health. They are afraid of being left by their husbands and children; they cannot neglect the fact of humiliation from the terrible smell they have or the inability to follow simple hygiene rules.
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