Maternal death

Maternal death
Other names	Maternal mortality
A mother dies and is taken by angels as her new child is taken away, A grave from 1863 in Striesener Friedhof in Dresden.
Specialty	Obstetrics

Maternal death or maternal mortality is defined in slightly different ways by several different health organizations. The World Health Organization (WHO) defines maternal death as the death of a pregnant mother due to complications related to pregnancy, underlying conditions worsened by the pregnancy or management of these conditions. This can occur either while she is pregnant or within six weeks of resolution of the pregnancy.^[1] The CDC definition of pregnancy-related deaths extends the period of consideration to include one year from the resolution of the pregnancy.^[2][3] Pregnancy associated death, as defined by the American College of Obstetricians and Gynecologists (ACOG), are all deaths occurring within one year of a pregnancy resolution.^[4] Identification of pregnancy associated deaths is important for deciding whether or not the pregnancy was a direct or indirect contributing cause of the death.

There are two main measures used when talking about the rates of maternal mortality in a community or country. These are the maternal mortality ratio and maternal mortality rate, both abbreviated as "MMR".^[5] By 2017, the world maternal mortality rate had declined 44% since 1990; however, every day 808 women die from pregnancy or childbirth related causes.^[6] According to the United Nations Population Fund (UNFPA) 2017 report, about every 2 minutes a woman dies because of complications due to child birth or pregnancy. For every woman who dies, there are about 20 to 30 women who experience injury, infection, or other birth or pregnancy related complication.^[6]

UNFPA estimated that 303,000 women died of pregnancy or childbirth related causes in 2015.^[6][7] The WHO divides causes of maternal deaths into two categories: direct obstetric deaths and indirect obstetric deaths. Direct obstetric deaths are causes of death due to complications of pregnancy, birth or termination. For example, these could range from severe bleeding to obstructed labor, for which there are highly effective interventions.^[8][1] Indirect obstetric deaths are caused by pregnancy interfering or worsening an existing condition, like a heart problem.^[1]

As women have gained access to family planning and skilled birth attendant with backup emergency obstetric care, the global maternal mortality ratio has fallen from 385 maternal deaths per 100,000 live births in 1990 to 216 deaths per 100,000 live births in 2015.^[6][7] Many countries halved their maternal death rates in the last 10 years.^[6] Although attempts have been made to reduce maternal mortality, there is much room for improvement, particularly in low-resource regions. Over 85% of maternal deaths are in low-resource communities in Africa and Asia.^[6] In higher resource regions, there are still significant areas with room for growth, particularly as they relate to racial and ethnic disparities and inequities in maternal mortality and morbidity rates.^[4][7]

Overall, maternal mortality is an important marker of the health of the country and reflects on its health infrastructure.^[4] Lowering the amount of maternal death is an important goal of many health organizations world-wide.