Maternal mortality: the magnitude and the causes

Studies in Family Planning, 1988

The views expressed in all papers are tlwse of the autlwrs or the organisation as specified in the paper, and slwuld not be attributed to the agencies or organisations sponsoring the Safe Motherhood Confertmce. BACKGROUND RAP.ERS 55 BACKGROUND PAPERS FOR SAFE MOTHERHOOD CONFERENCE

Journal of Biosocial Science, 1989

Pakistan Journal of Medical and Health Sciences, 2022

Aim: To determine the prevalence and reasons for maternal mortality at a tertiary care hospital Study design: A retrospective study Place and duration: This study was conducted at Maternal and Child Care Center Hyderabad Pakistan from June 2018 to June 2020. Methodology: To gain access to the records, convenience sampling was utilized. A self-contained proforma was used to gather verified data on variables (age, year of death, cause of death, and domicile), Excel 2016 was used to examine the data and trend analysis was performed using Join point Analysis Software. Results: In three years, 279 maternal fatalities have been reported from "Hyderabad." With 29.4 % (CI= 0.68, SD= 10.42), hemorrhage remained the primary cause, subsequently, eclampsia 16.13 % (CI= 0.63, SD= 7.48), ruptured uterus 8.6 % (CI= 0.56, SD= 8) and sepsis 5.73 % (CI= 0.44, SD= 5.47). The highest rate of maternal fatalities was 40.50 % in women aged 26 to 30, followed by 25.1 % in women aged 15 to 25, 21.15 % in women aged 31 to 35, and 13.26 % in women aged 36 to 40. The P-value for post-partum bleeding was significant (0.003). Conclusion: Maternal mortality continued to increase in women of child bearing age, with principal reasons including hemorrhage, eclampsia, uterine rupture, and sepsis. To avoid these deaths, early referral, decreasing cesarean section rate, improved monitoring during labour and maternal care by skilled personals and community-based education are both in desperate need of improvement.

BJOG: An International Journal of Obstetrics & Gynaecology, 2005

The purpose of this article is to review current strategies for the reduction of maternal mortality and the evidence pertinent to these strategies. Historical, contextual and current literature were examined to identify the evidence base upon which recommendations on current strategies to reduce maternal mortality are made. Current safe motherhood strategies are designed based mostly on low grade evidence which is historical and observational, as well as on experience and a process of deductive reasoning. Safe motherhood strategies are complex public health approaches which are different from single clinical interventions. The approach to evidence used for clinical decision making needs to be reconsidered to fit with the practicalities of research on the effectiveness of strategies at the population level. It is unlikely that any single strategy will be optimal for different situations. Strengthening of the knowledge base on the effectiveness of public health strategies to reduce maternal mortality is urgently required but will need concerted action and international commitment.

Journal of SAFOG, 2013

Objective To analyze the cases of maternal mortality over a period of 3 years with regard to direct, indirect and associated causes and social correlates. Materials and methods Retrospective evaluation of the cases with respect to causes, admission to mortality interval, age, parity, antenatal booking, socioeconomic status, etc. and systemic analysis of all contributing factors. Result and observation A total of 66.67% of the deaths were due to direct causes with obstetric hemorrhage being the most common cause followed by puerperal sepsis. Anemia was the most important indirect cause followed by hepatitis and cardiovascular diseases. Conclusion A large number of maternal deaths seem to be avoidable if we are able to strengthen our maternity and child health services. Equally important, however, remains the upgradation of the status of females in the society with emphasis on literacy and general health awareness. How to cite this article Soni M, Agrawal S, Soni P, Mehra H. Causes of...

Bulletin of the World Health Organization, 1999

Reducing maternal mortality is one of the major challenges to health systems worldwide, more so in developing countries that account for nearly 99% of these maternal deaths. Lack of a standard method for reporting of maternal death poses a major hurdle in making global comparisons. Currently much of the focus is on documenting the "number" of maternal deaths and delineating the "medical causes" behind these deaths. There is a need to acknowledge the social correlates of maternal deaths as well. Investigating and in-depth understanding of each maternal death can provide indications on practical ways of addressing the problem. Death of a mother has serious implications for the child as well as other family members and to prevent the same, a comprehensive approach is required. This could include providing essential maternal care, early management of complications and good quality intrapartum care through the involvement of skilled birth attendants. Ensuring the availability, affordability, and accessibility of quality maternal health services, including emergency obstetric care (EmOC) would prove pivotal in reducing the maternal deaths. To increase perceived seriousness of the community regarding maternal health, a well-structured awareness campaign is needed with importance be given to avoid adolescent pregnancy as well. Initiatives like Janani Surakhsha Yojna (JSY) that have the potential to improve maternal health needs to be strengthened. Quality assessments should form an essential part of all services that are directed toward improving maternal health. Further, emphasis needs to be given on research by involving multiple allied partners, with the aim to develop a prioritized, coordinated, and innovative research agenda for women's health.

Obstetric Medicine, 2008

Every year some eight million women suffer preventable or remediable pregnancy-related complications and over half a million will die unnecessarily. Most of these deaths could be averted at little or no extra cost, even where resources are limited, but in order to take action, and develop and implement changes to maternity services to save mothers and newborns lives, a change in cultural attitudes and political will, as well as improvements in the provision of health and social care, is required. Further, to aid programme planners, more in-depth information than that which may already be available through national statistics on maternal mortality rates or death certificate data is urgently needed. What is required is an in-depth understanding of the clinical, social, cultural or any other underlying factors which lead to mothers' deaths. Such information can be obtained by using any of the five methodologies outlined in the World Health Organizations programme and philosophy for maternal death or disability reviews, 'Beyond the Numbers', briefly described here and which are now being introduced in a number of countries around the world.

Midwifery, 1993

In 1987 an international project, the Safe Motherhood Initiative, was commenced with the aim of reducing, by half by the Year 2000, the 500000 maternal deaths which occur each year throughout the world. In this paper the progress of the Initiative is described and reviewed. The crucial role of the midwife in reducing maternal mortality is recognised and the work to be done in the future is identified. This paper was given as a keynote address at the 23rd Congress of the International Confederation of Midwives in Vancouver in May, 1993.