MCN_LEC_PRELIMS

• Every minute, a woman dies in childbirth or from complications of pregnancy
• More than 500,000 women die each year; almost all (95%) occur in developing countries
• For every woman who dies as many as 30 others suffer chronic illness or disability
• Maternal mortality is the health indicator with the most disparity between developed and developing countries
• The cumulative lifetime risk of dying as a result of pregnancy is 1:2800 in developed versus 1:16 in developing countries
• Maternal mortality trends are unacceptable, but not insurmountable because the major causes are known and avoidable
• Major causes of maternal deaths

  • Hemorrhage
  • Obstructed labor
  • Pregnancy induced hypertension
  • Sepsis/infection
  • Complications of unsafe abortion
• Interventions can be made available even in resource-poor settings
• Safe Motherhood Initiative


  1987
• World Summit for Children

  1990
• International Conference on Populations and Development

  1994
• 4th World Conference on Women

  1995
• Millennium Summit/Declaration

  2000
• Sustainable Development Goals (SDGs)

  2015
• Moral imperative


  The death of a woman during pregnancy or childbirth is a violation of her rights to life and health
• Social implications


  • Maternal death or disability can plunge families into poverty and deeper despair; surviving children esp. those < 5 years old are at risk of dying since no one will attend to their needs
  • The loss may reverberate throughout an entire community
• Maternal Death


  The death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not accidental or incidental causes
• It is a rare event and therefore its number may not be large enough to detect statistically significant changes over time
• Underreporting - especially if most occur outside of health facilities (in the absence of health personnel to report them)
• Misreporting because of the complicated definition requiring also its cause and timing OR sometimes done intentionally to avoid legal action
• Maternal Mortality Ratio (MMR)


  Number of women who die from pregnancy related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births
• Philippines maternal mortality rate for 2015 was 114.00, a 2.56% decline from 2014
• Philippines maternal mortality rate for 2014 was 117.00, a 3.31% decline from 2013
• Philippines maternal mortality rate for 2013 was 121.00, a 3.97% decline from 2012
• Philippines maternal mortality rate for 2012 was 126.00, a 0.79% decline from 2011
• Lessons learned: Most maternal deaths and disabilities would be averted if

  • All pregnancies are wanted and planned
  • All pregnancies are adequately managed throughout its course
  • All births are attended by skilled health professionals (ideally facility-based)
  • All complications are managed in adequately-staffed and equipped facilities offering emergency obstetric care
• Strategies to Reduce Maternal Mortality

  • Universal access to contraceptive services to reduce unintended pregnancies
  • Skilled attendance at all births