University of Botswana Law Journal - PULP

56 UNIVERSITY OF BOTSWANA LAW JOURNAL DECEMBER 2010
approaches can add a critical impetus to existing means of reducing maternal
mortality.” 67 Burns Weston has examined child labor as a multidimensional
human rights problem and elaborated a “multifaceted problem-solving/policyimplementing
typology” that outlines human rights strategies for all actors
(from individuals to states) in the international community to work to abolish
child labor. 68 Though this paper will not go as in depth as Weston has in
outlining his typology, I also seek to provide policy alternatives for both
individuals and states to utilize existing international law, and to go beyond
using only the law, to prevent global maternal mortality. As Weston writes in
the child labor context:
Though formal legal institutions and procedures created specifically
to promote and protect human rights are indispensable components
of a comprehensive strategy for the abolition of child labor, they are
by no means the only components – indeed, not even the most
effective or important in many instances. As previously stated, the
abolition of child labor requires broad and deep social change, and
for this is needed far more than the formal legal establishment, even
when dedicated specifically to the promotion and protection of
human rights. 69
Weston argues that bottom-up or grass roots approaches, approaches
in what he names “extra-legal” realms, are intrinsic to the approaching the
problem of child labor. 70 Similarly, solving the problem of global maternal
death requires “extra-legal” approaches, and such approaches must be grass
roots or bottom-up to address the local reasons that the human right to
maternal health care is not being recognized.
Maternal death is universal. While the problems of maternal and
infant mortality are most acute in developing countries, women in rich and
medically advanced nations like the United States also still face shocking
barriers to receiving adequate services during pregnancy and childbirth. 71
67 K. Hawkins, Developing a Human Rights-Based Approach to Addressing Maternal Mortality: Desk
Review (DFID Health Resource Centre 2005).
68 B. Weston, Child Labor in Human Rights Law and Policy Perspective, in Human Rights in Labor and
Employment Relations: International and Domestic Perspectives, chapter 4 at 73-121 (Labor and
Employment Relations Association Series, J. A. Gross & L. Compa eds., 2009).
69 Id. at 104.
70 Id. at 105.
71 Disparities in access to primary health care between populations in the United States based on race and
socioeconomic status are well documented. The 2008 National Health Care Disparities Report mandated
by Congress in 42 U.S.C. 299a1(a)(6) noted that “Americans too often do not receive the care they need
or they receive care that causes harm.” Agency for Health Care Research and Quality, 2008 National
Health Care Disparities Report 1 (March 2009) available at http://www.ahrq.gov/qual/nhdr08/
nhdr08.pdf. With regard to maternal health care, the 2008 report found that the rate of pregnant African-
American women who did not receive prenatal care in the first trimester was 1.6 times higher than the rate
for white American pregnant women; for American Indian and Alaska Native women, the rate of
pregnant women not receiving prenatal care in the first trimester was 2.1 times higher than white