Macroethical responsibilities of societies of gynaecologists and obstetricians.

The theme of maternal mortality and morbidity is of transcending macroethical importance. High rates of maternal mortality and morbidity can be significantly reduced by cost-effective means that are not dependent on advanced biotechnology. It has been shown that a major cause of maternal mortality comes from women (i) bearing children too early or too late in their reproductive lives, (ii) too frequently or at insufficiently spaced intervals. If women were able to control their fertility in order not to have children at unwanted times in periods of their life when pregnancy is inimical to their health, the incidence of maternal mortality and morbidity would drop. Improved standards of women's education, both in general and in particular regarding women's reproductive health, would reinforce the understanding of how to protect and improve one's reproductive health, and would accelerate the decline of maternal mortality and chronic morbidities. Accordingly, the macroethical demands of respect for autonomy, beneficence and justice would coincide. The value of justice would be served not only regarding women themselves, particularly those who have traditionally been vulnerable by virtue of their growing age, or dependent status in their communities, but also regarding the children dependent on such women, and families also dependent on the services of such women, like mothers, wives, daughters and grand-daughters.