An introduction for non-medical audiences

Dr Max Mongelli

Nepean Clinical School

University of Sydney

What is a maternal death

World Health Organisation:

• "the death of a woman while pregnant or within 42 days of

termination of pregnancy, irrespective of the duration and

site of the pregnancy, from any cause related to or

aggravated by the pregnancy or its management but not

from accidental or incidental causes”

Scale of the problem

• Every day, approximately 830 women die from preventable

causes related to pregnancy and childbirth.

Death during pregnancy is rare

• World-wide average risk is about 1:500 pregnancies

• Risk varies widely from country to country, not always

related to economic conditions

• Highest in Africa and southern Asia

• The USA has the highest among developed countries

• Overall decreasing trend over time

Risk is higher among:

• Very young mothers (aged 15 years or less)

• Limited access to health care

• Those living in rural areas

• Poverty and low income

• Social isolation, poor family support

• Areas with lack of skilled medical care

Most common causes of death:

• Bleeding after delivery (“postpartum hemorrhage”)

• Complications from unsafe abortions

• High blood pressure conditions of pregnancy

• Infections after delivery (“puerperal sepsis”)

• Obstructed labor

• Blood clots

• Malaria

• Anemia

• HIV/AIDS

How can it be prevented?

Most maternal deaths are avoidable

• Avoid unwanted pregnancy (contraception)

• Antenatal care (at least 4 visits)

• Skilled birth attendants/midwives with access to doctors

• Emergency obstetric care facilities

• Availability of antiseptics, antibiotics and blood transfusion

• Post-delivery care including follow-up

Support :

• Project Hope: www.projecthope.org

• UNICEF: www.unicef.org

• CARE: www.care.org