The Invisible Barrier in Healthcare Beyond Reproduction
In medicine and public discourse, there is one invisible yet deeply rooted pattern: when we talk about women’s health, the conversation is almost always connected to motherhood.
When governments, international organizations, and media platforms discuss priorities in women’s healthcare, the focus is predominantly placed on reproductive health, pregnancy, childbirth, and infant care. Of course, these are critically important issues. But what happens to a woman during the period when she is not yet a mother, or after she has passed reproductive age?
Modern medicine often makes a fundamental mistake: it views women as demographic and reproductive instruments rather than as individuals who need equal, comprehensive, and high-quality medical care throughout their entire lives.
The World Health Organization (WHO) Regional Office for Europe has published an alarming and thought-provoking analysis demonstrating that this “stigmatizing focus” within healthcare systems can have serious consequences for women’s quality and length of life, particularly beyond their reproductive years.
The Illusion of Medical Progress: Progress With Limits
Over the past two decades, maternal mortality has declined significantly across the WHO European Region. Today, more than 98% of births in the region take place in healthcare facilities, while approximately 99% are attended by skilled health professionals. This is undoubtedly a major achievement. Yet this progress has reached its limits:
- Stagnation: Since 2013, the decline in maternal mortality has slowed, while in some parts of Eastern and Northern Europe, rates have even increased.
- Preventable deaths: Between 2018 and 2022, more than 3,500 women died in the European Region from causes related to pregnancy and childbirth. These are cases in which the vast majority of deaths could have been prevented through effective healthcare interventions.
Beyond Childbirth: A Life Marked by Chronic Illness
While maternal mortality remains a major focus, the greatest burden of illness and mortality among women occurs beyond their reproductive years.
- Longer lives, but not necessarily healthier ones: Statistics show that women live longer than men, but this does not necessarily mean they enjoy a better quality of life. Compared with men, women spend significantly more years living with chronic diseases and disabilities.
- Geographical inequality: Since 2000, a significant gap has persisted between female mortality rates in Central Asia, Eastern Europe, and Western Europe. Women living in Eastern Europe die considerably earlier and more frequently, and this inequality has remained largely unchanged for more than two decades.
“Ill-Defined Causes” and Diagnostic Neglect
One of the most concerning findings of the analysis concerns how the healthcare system records deaths among women aged 45 and older.
A 14% Higher Risk
Among women aged 45 and over, the cause of death is 14% more likely to be classified as an “ill-defined cause” than among men of the same age.
What does this mean?
Medical records may list broad or vague explanations such as “frailty due to old age,” “cardiac arrest,” “unspecified dementia,” or simply “unknown cause.”
A Systemic Failure
This cannot be explained solely by the complexity of health conditions associated with ageing. There is growing evidence that women are often diagnosed later, particularly in the case of cardiovascular diseases; they may undergo fewer in-depth investigations, and historically, women have been underrepresented in clinical research.
Healthcare systems must move beyond frameworks that view women primarily through the lens of fertility, childbirth, and demographics. Equal attention, early diagnosis, and adequate representation of women in medical research are not privileges. They are fundamental rights that every woman should have access to throughout every stage of her life.
The Georgian Context: Free Screening Programs as a Positive Exception
Against a global and European healthcare landscape in which women’s health is often criticized for being neglected as they age, Georgia’s example deserves attention.
In many countries around the world, including developed nations, cancer screening is either largely dependent on private insurance or involves procedures that can be expensive, leaving many women without access to preventive healthcare.
In Georgia, however, the National Center for Disease Control and Public Health (NCDC) and municipal oncology screening programs, including those implemented in Tbilisi, provide women with completely free screening services, including:
- Breast cancer screening (mammography) — for women aged 40 to 70;
- Cervical cancer screening (Pap test and HPV testing) — for women aged 25 to 60;
- Early detection of other pathologies of the female reproductive system.
These are precisely the kinds of tools that can help women maintain their health beyond their reproductive years, prevent serious complications, and detect potentially dangerous diseases at an early stage.
The existence of these screening programs in Georgia demonstrates that access to preventive medicine is not a luxury but a vital necessity.
However, one major challenge remains: raising public awareness, so that every woman takes advantage of these free opportunities and understands that caring for her health should not be limited to the period of motherhood.
Source
Organization: World Health Organization (WHO), Regional Office for Europe
Article: More than a mother — a deep dive into women’s health and mortality
https://www.who.int/europe/news/item/18-08-2026-more-than-a-mother–a-deep-dive-into-women-s-health-and-mortality