Maternal Mortality Rate, Causes, and Prevention

When you’re having your first child, it’s exciting to think about holding your baby for the first time and all the beautiful moments you’ll spend together. But, it can also be scary when you don’t know what to expect. Many soon-to-be moms worry about childbirth, anesthesia, and complications. It is even normal to wonder about the chances of dying.

But, if you live in a country like the United States, you can breathe a sigh of relief. In developed countries, dying during childbirth or because of pregnancy is very rare, even if your pregnancy is high-risk. Here is what you need to know about the rate, causes, and prevention of maternal mortality.

What Is Maternal Mortality?

When a woman dies from anything having to do with pregnancy, it is called maternal mortality or maternal death. Maternal death can happen while a woman is pregnant, during labor and delivery, or in the 42 days after childbirth or the termination of pregnancy.

If a woman passes away from an accident or a health issue that doesn't have anything to do with the pregnancy, then it is not considered a pregnancy-related death.

United States Statistics

In countries with a good economy, modern technology, and access to healthcare, the chances of dying during pregnancy, in childbirth, or in the days and weeks after delivery are very low. In places such as the United States, the United Kingdom, and Canada, most women have healthy pregnancies and births. Of course, there is still a small risk of maternal death, even in developed countries.

According to the Centers for Disease Control and Prevention (CDC), approximately 700 women a year die from complications having to do with pregnancy in the United States. Health officials report the rate of maternal mortality as how many women die for every 100,000 live births.

There are around 4 million births in the United States each year, and in 218 there were approximately 17 maternal deaths for every 100,000 live births.

Worldwide Statistics

Other developed countries have similar and even lower maternal mortality rates when compared to the United States. However, that is not the case everywhere.

Throughout the world in 2017, about 295,000 women died from problems that arose during pregnancy and childbirth. Where about 700 women die each year in the U.S., the World Health Organization (WHO) reports that approximately 810 women died each day worldwide in 2017.

Most of these women (94%) live in poor, developing countries. In some places, the odds of dying because of pregnancy are as high as 1 in 45. And, the sad fact is that many of these deaths are preventable.

Contributing Factors

As you can see, where you live has a significant impact on your health and well-being as a pregnant woman. Other things that influence the risks involved with being pregnant are:

Age

Women in their twenties tend to have fewer complications during pregnancy than younger or older women. Young girls under the age of 15 have a much greater chance of complications that can lead to death. The risks also go up with advanced maternal age and increases as women become pregnant in their late 30s, or in their 40s and 50s.

Socioeconomic Status

Poor women in a lower socioeconomic group may have less education, a poor diet, and barriers to healthcare. Less education contributes to an earlier or unplanned pregnancy. Lack of nutrition can lead to health deficiencies and poor pregnancy outcomes. Not getting quality care puts women at risk for infection or other complications that could otherwise be managed and treated by a skilled healthcare provider.

Gender Inequality

In some countries, girls and women have fewer opportunities to get an education. They are often denied financial resources and do not have a say in their own lives and family choices.

Available Resources

For many women, medical care is far away and difficult to reach. The lack of prenatal care, delivering a baby without someone skilled in attendance such as a doctor, midwife, or nurse, and not having access to treatments such as antibiotics and emergency services can have life-threatening consequences.

Parity

Parity is the number of times a woman has been pregnant. The chances of having an issue with pregnancy or problems during childbirth are a little higher in a first pregnancy. The odds are less in a second pregnancy. But, after five or more pregnancies the risk grows once again.

Causes

In the United States, severe complications of pregnancy and maternal death are rare. With proper medical care, most of the problems that come about during pregnancy, childbirth, and the postpartum period can be treated or even prevented.

However, in other parts of the world, these conditions are more dangerous. Here are the leading causes of maternal mortality.

Postpartum Hemorrhage

Postpartum hemorrhage (PPH) is excessive bleeding and loss of blood after childbirth. A skilled health care provider can usually stop the bleeding. But, if a healthcare provider with the proper knowledge and skills is not available, a mother can die from losing too much blood.

High Blood Pressure and Eclampsia

Prenatal care and testing usually pick up issues such as high blood pressure and protein in the urine. With good medical care, doctors can treat and monitor pre-eclampsia. But, without care, it can become dangerous and lead to death. Hypertensive disorders are responsible for anywhere from 13.3% to 15.9% of pregnancy-related deaths.

Infection

Women can get an infection from unsafe abortion, unsanitary delivery, or very long labor. A lack of understanding and information on personal hygiene and how to care for the body after childbirth can also put a mom at risk for infection. About 11 percent of maternal deaths are the result of an infection.

Termination of Pregnancy

According to a report on abortion surveillance by the CDC, "Deaths of women associated with complications from abortion for 2015 are being assessed as part of CDC’s Pregnancy Mortality Surveillance System. In 2014, the most recent year for which data were available, six women were identified to have died as a result of complications from legal induced abortion."

However, in other areas of the world, unsafe abortion is a leading cause of death among women who have unintended pregnancies. According to WHO, 4.7% to 13.2% of maternal deaths each year can be attributed to unsafe abortion.

Pulmonary Embolism

A pulmonary embolism (PE) is a blood clot in the lungs. PE can develop after delivery, and the risk is higher with a cesarean section. About 9.2% percent of maternal deaths are due to pulmonary embolism.

Other Direct Complications

Approximately 10 percent of women die from other direct pregnancy-related issues. Conditions such as placenta previa, uterine rupture, and ectopic pregnancy can lead to complications and death without proper care and treatment.

Other Indirect Causes

An indirect cause of death in pregnant women is from a condition that is not directly related to the pregnancy but develops or gets worse during pregnancy. Pregnancy can affect health problems such as HIV and heart disease. Conditions such as diabetes and anemia can develop or get worse. These issues account for approximately 28 percent of maternal deaths.

Making Pregnancy Safer

Between 1990 and 2015, the number of women dying because of pregnancy and childbirth has gone down by 44%. The decrease is due to:

• The education of women
• An increase in the use of contraception
• More prenatal care
• More births in hospitals or with skilled health care providers present
• Greater availability of antibiotics, blood transfusions, and treatments for complications
• Advances in specialized care for high-risk pregnancies and deliveries

But, in many parts of the world, more work needs to be done. To lower maternal mortality rates where they are the highest women need:

Education

Young women (and men) who know more about reproduction, fertility, birth control, and the consequences of unprotected sex can make better choices for themselves. Family planning information can prevent unplanned pregnancy and unsafe abortions.

Access to Health Care

Healthcare, management of pre-existing conditions, and the availability of safe procedures can prevent death during pregnancy. Nutrition services and reproductive health services are especially important for girls and young women.

Cleanliness

The knowledge of good personal hygiene practices and how to care for the body can keep germs away. Regular handwashing, a clean perineal area during prenatal check-ups, and a hygienic delivery area during childbirth can also help to prevent infection.

Pregnancy Care

Skilled care before and during childbirth can prevent complications and lead to a safe birth. If possible, women should have their babies a healthcare facility. If delivery in a hospital, clinic, or office is not possible, then someone skilled at delivering children should be at home deliveries.

Postpartum Monitoring

After childbirth, women continue to need care. Postpartum checkups for abnormal bleeding or infection can make all the difference. Living far from services or not being able to afford them can prevent a woman from gaining the knowledge she needs to care for herself after the birth or to get the life-saving antibiotics and the postpartum attention she may need.

C-Section Death Statistics

In developed countries, the chance of dying from a cesarean section is still rare, but it’s a little higher than a vaginal delivery. A study published in 2008 in the American Journal of Obstetrics and Gynecology found that maternal mortality is 2.2 per 100,000 for c-sections and 0.2 per 100,000 for vaginal births. The reason a cesarean section has a higher rate is that it's a surgery, and surgery has some risks.

Complications from a C-section that could lead to maternal death include:

• Infection
• Blood clots
• Anesthesia reactions
• Blood loss
• Injury to other organs during surgery

But, keep in mind that C-sections save lives, too. There are times when a C-section is the best option. When it's necessary, a cesarean can lower the chances of maternal death as well as neonatal death and make delivery a lot safer.

A Word From Verywell

In the past, pregnancy and childbirth were more dangerous. But, today, it’s so much safer to have a baby. If you get regular prenatal care, eat well, make good lifestyle choices, and have a skilled health practitioner at your delivery, the chances of having a healthy pregnancy and birth are excellent.

However, in some parts of the world women continue to face difficult circumstances surrounding pregnancy and childbirth. Just like many other women, they have the same hopes and fears about having a child. Unfortunately, their fears are well-founded. But, so is their hope.

Maternal and child health organizations such as WHO, USAID, UNICEF, UNFPA, and many others are bringing awareness to this issue. They are developing programs to help fight maternal mortality and make the future better for all women.

If you would like to get involved, you can look for opportunities to help those less fortunate in your community or make a difference by lending support to organizations such as these that are trying to bring life-saving education, medication, and care to women around the world.