More than half a million women still die every year in pregnancy or after childbirth in spite of two decades of efforts to bring down the toll, reports revealed on Friday.

Little has changed, particularly in much of the developing world. Women die of avoidable complications such as high blood pressure or haemorrhage in childbirth - and often the baby dies too or does not survive the next few years without a mother. Tens of thousands die painfully in backstreet abortions in countries where contraception is not readily available and abortion is heavily restricted or banned.

Alexandra Novak practices during a course for pregnant women at a hospital in Warsaw, Poland, on  March 14, 2007. (Xinhua/Reuters File Photo)

Papers prepared for a major conference in London next week and published in the Lancet on Friday reveal the scale of the failure. New figures show it is highly unlikely that the Millennium Development Goal 5 - to slash death rates by 75 percent from their 1990 level by 2015 - will be achieved.

In 1990 it was estimated that 576,300 women died in pregnancy, labor or after giving birth. The latest calculations, from the Harvard Center for Population and Development Studies in Cambridge, Massachusetts, show that 15 years later, in 2005, some 535,900 died. The maternal mortality ratio dropped from 425 in 100,000 to 402 in 100,000.

But that, says Ken Hill, lead author of the paper, is a best estimate. Because of the lack of data from some of the countries with the worst death tolls, calculations have to be based on better performing countries that do collect figures. That makes it look as though there has been a drop of 2.5 percent in the mortality rate a year but it could be as low as 0.4 percent.

"0.4 percent unfortunately I think is the more realistic figure for the globe as a whole," said Professor Hill. "The proportion of sub-Saharan African births is going up and maternal mortality is not going down."

Abortion rates have dropped, mostly due to a big rise in contraceptive use in Eastern Europe. Globally numbers came down from 46 million in 1995 to about 42 million in 2003. But the picture in Africa and parts of Asia remains dire and some experts accuse the Bush administration of worsening the problem due to its anti-contraception, pro-abstinence policies there.

"There couldn't be a better set of findings to show the failure of the Bush administration policy - the emphasis on abstinence and monogamy, the obsession with abortion, the defunding of good family planning organizations because they talk about abortion," said Sharon Camp, president and CEO of the Guttmacher Institute, which carried out the abortion study with the World Health.

(Agencies via China Daily October 14, 2007)