By Julie Guinan, CNN
Aug. 12, 2015 | CNN Español
This is a difficult statistic to understand and even more difficult to ignore in the second decade of the century.
According to the World Health Organization, nearly 800 women die each day from complications related to pregnancy and childbirth worldwide.
All but 1% of these deaths occur in developing countries and perhaps most tragic of all is that 80% of them are preventable.
When speaking of maternal deaths, much of the focus is on Africa, which represents about 50% of global statistics.
But the problem goes far beyond the borders of sub-Saharan Africa; Guatemala, in Central America, has the highest maternal and child mortality rates in the region.
Maternal mortality in Guatemala
While in Guatemala maternal deaths have decreased since the United Nations included improving maternal health in their Millennium Development Goals in 2000, the rate is still unacceptably high.
According to WHO, 140 deaths occur for every 100,000 births. Most of these deaths occur among indigenous peoples, most of them Mayans where poor women are the least likely to receive adequate medical care and where fertility rates are highest.
Poor maternal health is one of the key issues at the center of the malnutrition crisis in Guatemala ... and very young children are the undeniable face of hunger. The first 1,000 days of a child's life - from conception to his or her second birthday - are the most important.
But in Guatemala, almost 50% of children under five are chronically malnourished to such a degree that they remain stunted for life, both physically and in their development, as indicated by UNICEF
According to the World Food Programme, Guatemala has the fourth highest rate of stunting in the world.
This can lead to severe developmental delays, poor performance in school and reduced productivity throughout their adulthood. But despite the many problems that can result from an unwanted pregnancy, many women have no say as to whether or not they get pregnant or how often.
Family planning, the big challenge
This can be particularly difficult in part because it is a patriarchal society where women's health is not considered a priority. But also because many families have much value and contraceptives are at odds with the culture and tradition.
Dr. Jenny Eaton Dyer is the executive director of Hope Through Healing Hands (HTHH) based in Nashville, Tennessee. Its aim is to educate Americans about family planning and maternal and child health around the world, and increase funding for these causes.
Earlier this year, Dyer traveled to Guatemala with the humanitarian organization CARE with a diverse delegation. The delegation traveled to Quetzaltenango, in the western highlands, to visit Mayan women and learn about nutrition, how to care for themselves and their newborns, and to discuss some of the main challenges they faced.
One of the main problems they found was that women had limited access to health services, especially in rural areas. Part of this is due to lack of transport, but also women have no influence on the decision-making process.
Because of this, many women don't space their pregnancies, as recommended by the UN to wait at least two years after delivery.
This creates another set of problems. Pregnancies too close together can lead to health problems for both mothers and newborns, and that's one of the underlying causes of child mortality.
Dyer said that educating families on this issue is a primary goal of HTHH. "If we can help empower women to improve both the timing and how long they wait between pregnancies, they have the opportunity to continue to study, get a job or a profession and become economically independent."
The benefit, according to Dyer, extends beyond the immediate family. "This then is a virtuous circle that women have healthier and stronger children, stronger families and ultimately, stronger nations."
Although programs designed to help indigenous women learn about the value of nutrition, family planning and healthy spacing of pregnancies, much remains to be done, not only in Guatemala but throughout the world.
The Faith-Based Coalition for Healthy Mothers and Children campaign says that maternal, newborn and child health, along with the healthy timing and spacing of pregnancies (HTSP) is "an axis of global health," and one of the most cost-effective and powerful strategies to empower women.
"If we are able to improve maternal health and child survival, mothers can return to work, which increases the GDP per capita for the family and fights extreme poverty and hunger," says Dr. Dyer.
"If family planning is linked, children can stay in school because if there are fewer children, parents can afford to pay for their education, women can stay in school and finish high school and even go to college if they can prevent pregnancy ... and if women can get an education and compete for jobs because they make healthy choices for themselves and their families, this supports maternal health promoting gender equality," she adds.