It took 30-year-old Zemzem 20 hours to get from her rural
village in Ethiopia to the nearest hospital for the delivery of
her fifth child. By the time she arrived, her uterus had
ruptured. But because health workers had the capacity to operate
quickly, as well as medicine to staunch the bleeding, and
antibiotics and equipment for a blood transfusion, they managed
to save the life of her and her baby. And because Ethiopia is
scaling up access to contraception, women like Zemzem can avoid
facing a risking pregnancy too soon. When 21-year-old Manakala
Darlami of Nepal began bleeding profusely after the birth of her
fourth child, members of the village safe motherhood committee
were called to help. Although it took three hours to get her to
the hospital, and blood donations to save her, Manakala pulled
through. In many countries of Latin America and in Viet Nam,
women who have been reluctant to seek trained obstetrical care
because of the insensitivity they once encountered now have
access to midwives and health