Half the Sky: Turning Oppression Into Opportunity for Women Worldwide

Kristof and WuDunn outline the reasons for maternal mortality in the first part of Chapter 7, “Why Do Women Die in Childbirth?” They begin with the story of Prudence Lemokouno. Like many women in rural Cameroon, Prudence received no prenatal care. The authors describe her experience:

She went into labor at full term, assisted by a traditional birth attendant who had had no training. After three days of labor, the birth attendant sat on Prudence’s stomach and jumped up and down. That ruptured Prudence’s uterus. The family paid a man with a motorcycle to take Prudence to the hospital (109).

The doctor at the hospital, Pascal Pipi, quickly realized that Prudence needed an emergency cesarean. However, the family couldn’t raise the necessary funds to cover this procedure, so Dr. Pipi refused to perform it. Kristof and WuDunn happened to be visiting the hospital. By the time they arrived, Prudence’s baby had died, and its decay was poisoning her. The authors were willing to donate blood and pay for the procedure to save Prudence’s life. However, Dr. Pipi had left for the day, and the staff refused to call him to come back. When he returned to the hotel, the infection had spread too much. Prudence’s family took her home, where she died. The authors note that this story occurs every minute.

Prudence and women like her die for four reasons. The first is biology. Some women’s pelvises are too small to allow a baby’s head to pass through. Preliminary research suggests that this condition is especially prevalent among African women. The second is lack of education. The authors suggest that higher levels of education correlate to smaller family sizes, higher income levels, use of contraception, and higher usage of hospitals during the birthing process. The lack of rural health systems is the third reason. The healthcare structure in rural areas is often completely inadequate and overwhelmed, especially for maternal health. The final reason is societal disregard for women. Kristof and WuDunn emphasize that “women die because they aren’t thought to matter” (115).

Poverty is another factor, but the authors suggest that high maternal mortality rates and poor countries don’t always correlate. As an example, Sri Lanka, despite being torn apart by war over the last few decades, maintains one of the lowest MMRs in the region because government officials invest in health, education, and gender equality.

To demonstrate measures that can save more women during childbirth, the authors turn to Edna Adan’s hospital in the second half of the chapter. After working for the World Health Organization, Edna started the first hospital in her country, Somaliland, with her life savings. Americans help raise funds for the hospital. Today, the hospital provides care to some of the most marginalized women in the world, considering that they live in a country that most governments don’t recognize as independent.

In “Family Planning and the ‘God Gulf,’” the first part of Chapter 8, Kristof and WuDunn focus on how politics in donor counties, such as the US, impact maternal mortality in the Global South. As one example, President George W. Bush cut funding to Marie Stopes International because it provided abortions in China. Rather than simply cutting funding to its China programs, however, President Bush cut funding to all the programs, including those that didn’t provide abortions in Africa. This decision eliminated healthcare for thousands of the most marginalized women in under-resourced countries.

The authors suggest that this incident reflects the “‘God Gulf’” (132) in American foreign policy, noting that “religion plays a particularly profound role in shaping policies on population and family planning, and secular liberals and conservative Christians regularly square off” (132). Republicans often cut funding, known as the “gag rule,” to aid groups that provide counseling to women on abortions, a decision partly driven by conservative Christians. Conservative Christians believe that the gag rule protects reproductive health. Studies document, however, that it has had unforeseen consequences, including higher rates of unwanted pregnancies and unsafe abortions. Contraception is one way to prevent unwanted pregnancies and reduce abortions, yet liberals and conservatives in the US can’t even agree on this. Kristof and WuDunn state that “one of the scandals of the early twenty-first century is that 122 million women around the world want contraception and can’t get it” (134).

In the chapter’s second half, the authors focus on “Jane Roberts and Her 34 Million Friends.” Jane is a retired schoolteacher from California. When President George W. Bush announced that he would withhold $34 million from the UN Population Fund (UNFPA), partly to punish China for its forced abortion policy (even though UNFPA wasn’t party to this policy), she decided to fight back. She published a letter in her local newspaper to ask 34 million Americans to join her in sending one dollar to UNFPA. Jane joined forces with other aid organizations and American women and successfully raised $34 million through grassroots efforts. They formalized this campaign with UNFPA, calling it 34 Million Friends.

In the first half of Chapter 9, after reviewing opinion polls and their own experiences in Middle Eastern countries, the authors ask, “Is Islam Misogynistic?” The historical answer is no. The authors note how “when Muhammad introduced Islam in the seventh century, it was a step forward for women” (150). Islamic law banned female infanticide, reduced the number of wives in a polygamous marriage, and allowed women to own property. Compared to early Christian leaders, Muhammad was more respectful of women.

To the authors, however, conservative Islam hasn’t moved beyond this seventh-century worldview—and in the 21st century, these attitudes are sorely outdated. While the major monotheistic texts endorse some degree of gender discrimination, “it has been much harder for pious Muslims to ignore unpleasant and antiquated passages in the Koran, because it is believed to be not just divinely inspired, but literally the word of God” (151). Some Islamic scholars and feminists, including Amina Wadud and Fatema Mernissi, are pushing for different interpretations of the Koran based on a better understanding of the sociocultural context in which it was written as well as language ambiguities. Change is starting to occur in the Middle East, largely due to women leaders and grassroots organizations.

The authors provide guidance on how aid projects can be more effective in the second part of Chapter 9, “The Afghan Insurgent.” Western aid efforts tend to be ineffective in Muslim countries, especially Afghanistan, because aid agencies fail to understand the cultural nuances. Kristof and WuDunn underscore the importance of getting local buy-in, especially that of the mullahs (or local religious leaders) in Taliban-controlled areas, and of keeping Westerner aid workers out of sight. Better yet, foreigners can donate to projects led by Afghan women.