World Maternal Mortality in 2005

Here is the link to the official World Health Organization’s “Maternal Mortality in 2005” estimates.

On the 12th page of this 48-page document, is a reason for some confusion of terms. Most people think “dying in childbirth” when they hear the term “Maternal Mortality”, but that is not necessarily what this means. “Pregnancy-related death” is the death of a woman while pregnant or within 42 days of the end of her pregnancy, regardless of how the pregnancy ended (miscarriage, stillbirth, abortion, live birth) and regardless of how she died (including accidental deaths, homicides, suicides, as well as any other reason, whether the situation was caused or exacerbated by her pregnancy or not). Most definitions of “maternal mortality” restrict the term to those deaths due to “direct” or “indirect” obstetric causes. In other words, any accidental or intentional deaths would not be counted, but deaths due to pregnancy-related hypertension or diabetes would be. These deaths are typically restricted to include only those within 42 days of the end of pregnancy; but since many countries have the capability of artificially extending life for long periods of time, there is also “late maternal mortality” which includes deaths from 6 weeks through 1 year after the end of a pregnancy, to more accurately reflect women who actually did die from pregnancy- or birth-caused problems, even if they survived the first 6 weeks. This would include a woman who finally succumbed to an post-op infection after fighting it for two months.

I’m not sure how some deaths would fit in — as an example, I’ll use the death of a woman in my own community a few years ago. She found out when she was in her 2nd trimester that she had an aggressive and deadly form of cancer. They waited until the baby was at 30 weeks before performing a C-section and then doing chemotherapy (her doctors suggested an abortion or an earlier C-section, for a better chance at saving her life, but she declined, so that her baby would have a better chance of life). Had she not been pregnant, chemo would have been started immediately, instead of waiting several weeks, and her life might have been saved. But maybe not. As it was, she only lived a couple of weeks after her baby was born. Was her cancer directly related to pregnancy? Possibly, but possibly not. Is her death “maternal mortality”? I don’t know if it was officially counted or not. It would be counted in “pregnancy-related” deaths, but I don’t know if it’s strictly “maternal mortality.”

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