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| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| Maternal death | 3/10 | https://en.wikipedia.org/wiki/Maternal_death | reference | science, encyclopedia | 2026-05-05T07:30:33.740084+00:00 | kb-cron |
=== Risk factors === According to a 2004 WHO publication, sociodemographic factors such as age, access to resources, and income level are significant indicators of maternal outcomes. Young mothers face higher risks of complications and death during pregnancy than older mothers, especially adolescents aged 15 years or younger. Adolescents have higher risks for postpartum hemorrhage, endometritis, operative vaginal delivery, episiotomy, low birth weight, preterm delivery, and small-for-gestational-age infants, all of which can lead to maternal death. The leading cause of death for girls at the age of 15 in developing countries is complications during pregnancy and childbirth. They have more pregnancies, on average, than women in developed countries, and it has been shown that 1 in 180 15-year-old girls in developing countries who become pregnant will die due to complications during pregnancy or childbirth. This is compared to women in developed countries, where the likelihood is 1 in 4900 live births. However, in the United States, as many women of older age continue to have children, the maternal mortality rate has risen in some states, especially among women over 40 years old. Women in low-income countries face a lifetime risk of maternal death—defined as the probability that a 15-year-old girl will die from maternal causes—of 1 in 66, versus 1 in 7,933 in high-income countries. Structural support and family support influence maternal outcomes. Furthermore, social disadvantage and social isolation adversely affects maternal health which can lead to increases in maternal death. Additionally, lack of access to skilled medical care during childbirth, the travel distance to the nearest clinic to receive proper care, number of prior births, barriers to accessing prenatal medical care and poor infrastructure all increase maternal deaths.
=== Causes of maternal death in the US === Pregnancy-related deaths between 2011 and 2014 in the United States have been shown to have major contributions from non-communicable diseases and conditions. The following are some of the more common causes related to maternal death: cardiovascular diseases (15.2%.), non-cardiovascular diseases (14.7%), infection or sepsis (12.8%), hemorrhage (11.5%), cardiomyopathy (10.3%), pulmonary embolism (9.1%), cerebrovascular accidents (7.4%), hypertensive disorders of pregnancy (6.8%), amniotic fluid embolism (5.5%), and anesthesia complications (0.3%). In June 2022, the U.S. Supreme Court overturned Roe v. Wade (Dobbs v. Jackson Women's Health Organization), removing federal abortion protections. By 2020, maternal mortality rates were 62 % higher in abortion-restriction states than in abortion-access states (28.8 vs. 17.8 per 100,000 births). Analysis of CDC data (2019–2023) indicates that mothers in abortion-ban states are twice as likely to die during pregnancy, childbirth, or postpartum than those in states with legal abortion access.
=== Three delays model === The three delays model describes three critical factors that prevent women from receiving appropriate maternal health care. These factors include:
Delay in seeking care Delay in reaching care Delay in receiving adequate and appropriate care Delays in seeking care are due to decisions made by pregnant women and/or other individuals. Decision-making individuals can include a spouse and family members. Examples of reasons for delays in seeking care include lack of knowledge about when to seek care, inability to afford health care, and women needing permission from family members. Delays in reaching care include factors such as limitations in transportation to a medical facility, inadequate medical facilities in the area, and a lack of confidence in medicine. Delays in receiving adequate and appropriate care may result from an inadequate number of trained providers, a lack of appropriate supplies, and a lack of urgency or understanding of an emergency. The three delays model illustrates that there are a multitude of complex factors, both socioeconomic and cultural, that can result in maternal death.
== Measurement == The four measures of maternal death are the maternal mortality ratio (MMR), maternal mortality rate, lifetime risk of maternal death, and proportion of maternal deaths among deaths of women of reproductive age (PM). Maternal mortality ratio (MMR) is the ratio of the number of maternal deaths during a given time period per 100,000 live births during the same time period. The MMR is used as a measure of the quality of a health care system. Maternal mortality rate (MMRate) is the number of maternal deaths in a population divided by the number of women of reproductive age, usually expressed per 1,000 women. The lifetime risk of maternal death is a calculated prediction of a woman's risk of death after each consecutive pregnancy. The calculation pertains to women during their reproductive years. The adult lifetime risk of maternal mortality can be derived using either the maternal mortality ratio (MMR), or the maternal mortality rate (MMRate). The proportion of maternal deaths among deaths of women of reproductive age (PM) is the number of maternal deaths in a given time period divided by the total deaths among women aged 15–49 years. Approaches to measuring maternal mortality include civil registration systems, household surveys, census, reproductive age mortality studies (RAMOS), and verbal autopsies. The most common household survey method, recommended by the WHO as time- and cost-effective, is the sisterhood method.