Maternal mortality due to pregnancy

In the Netherlands, fewer and fewer women are dying during or just after their pregnancy. Unfortunately, it still happens several times every year. This is mainly due to pre-eclampsia, what is this and what are the symptoms? Abroad, mainly in Africa, death during pregnancy or immediately afterwards is unfortunately much more common. What are the global statistics regarding death during or after pregnancy?

Maternal mortality due to pregnancy in the Netherlands

Numbers

In the period from 1993 to 2005, 414 women in the Netherlands died due to pregnancy. This amounts to at least 20 deaths per year. However, this is still less than 1 in 6,000 women. Of these 414 women, 236 died directly, the others died after the birth of the child. The risk of dying during pregnancy is greater when: The woman is older (35+), the woman is overweight, or the birth was accomplished by caesarean section. Fortunately, the mortality rate for women during pregnancy is gradually decreasing. In 1950, there were still 241 known deaths, while in 2013 there were only 12 known deaths during pregnancy. The main cause of maternal death during pregnancy in the Netherlands is pre-eclampsia. Other causes may include: High blood pressure, existing diseases that complicate the pregnancy and other complications during the maternity period.

Preeclampsia

Pre-eclampsia is defined as high blood pressure and too high a protein content in the urine. Preeclampsia usually occurs between the 18th and 22nd week of pregnancy. If preeclampsia is diagnosed in time, you will be faced with a difficult but sometimes necessary decision. If you have suffered pre-eclampsia, there is a chance that you or your baby will not emerge healthy. This can even lead to death. Some symptoms of pre-eclampsia are:

• Higher than normal blood pressure (140/90 mm of mercury or higher)
• Too much protein in the urine (Proteinuria)
• Often suffer from severe headaches
• Occasionally suffer from reduced vision such as blurred vision or sensitivity to light
• Pain just below the ribs
• Frequently suffer from nausea and/or vomiting
• Lots of dizziness
• Less need to urinate
• Sudden increase in weight (at least 2 kilos)
• Swelling of the face (cheeks) or hands.

Preeclampsia is more likely to occur in women who are pregnant for the first time, are under 20 or over 40, are obese and/or are expecting multiple births (twins, triplets, etc.).

Maternal mortality due to pregnancy worldwide

Worldwide, more than 500,000 women still die every year during or just after pregnancy. Of this number, 95% come from countries in Africa and Asia. Research has been done on maternal mortality worldwide and these are some of the results.

As you can see, maternal mortality during pregnancy is most common in Africa. This also varies considerably per country.

Causes of maternal mortality in these countries

Top 5 causes

In these African countries where maternal mortality occurs much more often than ours, the causes are also very different than ours. As previously mentioned, pre-eclampsia is the number 1 cause in the Netherlands. The top 5 causes worldwide for maternal death during childbirth are:

1. Bleeding
2. Blood poisoning
3. Unsafe abortion
4. Difficult delivery
5. High bloodpressure

Lack of contraceptives

Because there are few contraceptives in many African countries, mothers do not have a choice about the number of children they have. They often do not choose to become pregnant. Contraceptives can also ensure that there are fewer teenage pregnancies in these countries. Teenagers (15 – 19 years) have a greater risk of complications during childbirth and pregnancy.

Little medical help

Many mothers in these countries give birth at home, often without a doctor present. When something goes wrong during childbirth, these women often do not have the opportunity to go to a hospital in time or to receive other help from doctors. Unfortunately, many women die as a result.

Difficult adolescence

Many girls suffer from stunted growth due to malnutrition, and many girls in these types of countries are also circumcised. These are two reasons why things often go wrong during childbirth.

Illegal abortion

Abortion is prohibited in many countries, yet illegal abortions are often performed in special areas. Often the medical help available is not good or professional. In the most serious cases, women bleed to death during this illegal abortion.