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Maternal death, obstetrical death, or maternal mortality are terms that all refer to the death of a woman during her pregnancy. This includes death during childbirth or shortly after childbirth. Deaths resulting from the termination of a pregnancy or a fatality within 42 days after terminating a pregnancy are also included in this definition.
There are several categories of maternal death that distinguish the reasons for a pregnancy-related fatality. Direct maternal death refers to any ending of life caused by a complication or mismanagement of the pregnancy or delivery. Indirect maternal death means the death of a pregnant woman as a result of a predated medical condition. A fatality that is an accident unrelated to the pregnancy is called a non-obstetric, incidental, or accidental death.
The main causes of direct maternal death are intense, mismanaged bleeding during delivery, infection, or obstructed labor. The latter condition refers to a woman who has small reproductive organs, usually due to malnutrition during childhood, making it extremely difficult and dangerous for her to bear a child. An unintended pregnancy that provokes an unsafe abortion is another common cause of direct death during pregnancy.
Puerperal fever is an infection that sets in soon after delivery. This type of contagion was historically one of the primary, direct causes of death during pregnancy. In underdeveloped countries, puerperal fever is still a significant cause of death following a delivery. The main reason for this infection is the absence of sterile conditions during delivery or when controlling bleeding following a delivery.
The primary causes of indirect death during pregnancy include anemia, the human immunodeficiency virus, and heart disease. Non-obstetric deaths are most often caused by tuberculosis and malaria. Accidental deaths may also be caused by a severe respiratory infection that occurs during gestation.
Maternal mortality is fairly unique to humans and is the result of a phenomenon called the obstetric dilemma. As the human race evolved into beings that moved in an upright position on two feet, the shape of the pelvic bone had to morph in order to bear the shifted weight distribution. The result was an attenuation of the pelvic opening through which the birth canal passes.
To compensate for this narrowing of the birth canal, gestation shortened so that the baby could pass through the birth canal while still small enough to fit. Despite this adaptation, birth for humans is difficult and is thereby associated with fatalities. This is especially true in areas where health care is poor or hard to reach in time for delivery.