Maternal Mortality: A Global Factbook

The global picture reports on the nature and medical and nonmedical causes of maternal mortality coverage of maternity care and an annotated bibliography and data sources are included.

Abstract

500000 women worldwide die each year from pregnancy related causes. Statistical data are provided for regions by country (those with >200000 population) on 1) basic indicators (population and rate of growth life expectancy fertility mortality); 2) social and economic measures (adult literacy by sex primary school enrollment by sex female mean age at first marriage gross national product (GNP) and calorie supply/capita daily); 3) health services (health expenditures as a percentage of GNP primary health care expenditure as a percentage of total health expenditure health facilities safe water adequate sanitary facilities and contraceptive prevalence rate); 4) community studies and data available by site; 5) hospital studies with data by site; 6) civil registration data or government estimates of maternal mortality and; 7) other sources of estimate. An annotated bibliography and data sources are included. The global picture reports on the nature and medical and nonmedical causes of maternal mortality coverage of maternity care and bibliography. The methods part focuses on definitions; rates and ratios; the reliability of official rates; community studies (household surveys sisterhood and indirect measures and reproductive age mortality surveys); health service records from hospitals and other sources of records; indirect indicators; and references. There is also an introductory section on definitions and explanations of the country profiles. 99% of maternal deaths occur in developing countries. The maternal mortality rate is highest for Asia particularly India Pakistan and Bangladesh (28% of the worlds births and 46% if the worlds maternal deaths). Africa has the next highest rate with 150000 women dying per year. Latin American maternal deaths amount to 34000/year. Pregnancy risks are highest in Africa. Historically this pattern is to be expected since even in the US maternal mortality was high in 1920 and high in England and Wales until 1935. The risk of dying at each pregnancy in a developing country is 1:140 while in Scandinavia it is 1:25000. The lifetime risk i s even higher or 1:23 with 6 pregnancies. 80% of deaths are related to anemia. Significant direct causes are hemorrhage puerperal sepsis hypertensive disorders obstructed labor and abortion. Indirect medical causes are anemia malaria and viral hepatitis. Nonmedical causes are limited access to care health service factors and social status.