Maternal death or maternal mortality is defined by the World Health
Organization (WHO) as "the death of a woman while pregnant or within
42 days of termination of pregnancy, irrespective of the duration and
site of the pregnancy, from any cause related to or aggravated by the
pregnancy or its management but not from accidental or incidental
There are two performance indicators that are sometimes used
interchangeably: maternal mortality ratio and maternal mortality rate,
which confusingly both are abbreviated "MMR". By 2017, the world
maternal mortality rate had declined 44% since 1990, but still every
day 830 women die from pregnancy or childbirth related causes.
According to the
United Nations Population Fund
United Nations Population Fund (UNFPA) 2017 report,
this is equivalent to "about one woman every two minutes and for every
woman who dies, 20 or 30 encounter complications with serious or
long-lasting consequences. Most of these deaths and injuries are
UNFPA estimated that 289,000 women died of pregnancy or childbirth
related causes in 2013. These causes range from severe bleeding to
obstructed labour, all of which have highly effective
interventions. As women have gained access to family
planning and skilled birth attendance with backup emergency obstetric
care, the global maternal mortality ratio has fallen from 380 maternal
deaths per 100,000 live births in 1990 to 210 deaths per 100,000 live
births in 2013, and many countries halved their maternal death rates
in the last 10 years.
High rates of maternal mortality still exist in places, particularly
in impoverished communities with over 85% living in Africa and
Southern Asia. The effect of a mother's death results in vulnerable
families and their infants, if they survive childbirth, are more
likely to die before reaching their second birthday.
1.1 Severe Maternal
3.1.1 Variation within countries
3.1.2 Maternal mortality in the United States
4.1 Medical technologies
4.2 Public health
6 See also
9 External links
According to a 2003 article in the British Medical Bulletin,
maternal death was first defined as "the death of a woman while
pregnant or within 42 days of termination of pregnancy, irrespective
of the duration and site of the pregnancy, from any cause related to
or aggravated by the pregnancy or its management but not from
accidental or incidental caused " in the tenth revision of the
International Classification of Diseases (ICD-10) which was completed
in 1992. It is the definition still in use by the World Health
Organization (WHO) defines maternal mortality as "the death of a woman
while pregnant or within 42 days of termination of pregnancy,
irrespective of the duration and site of the pregnancy, from any cause
related to or aggravated by the pregnancy or its management but not
from accidental or incidental causes."
The 2003 article "Global burden of maternal death and disability"
noted that the definition leaves out a segment of the population.
According to the Centers for Disease Control, during the period
1974-75 in Georgia, US, 29% of maternal deaths "occurred after 42 days
of pregnancy termination and 6% occurred after 90 days
Although "severe maternal morbidity" (SMM) has become a "pervasive
problem" and the rate of SMM is "rapidly increasing", SMM does not yet
have a "single, comprehensive definition".
According to a June 2017 article published in the Canadian Medical
Association Journal (CMAJ) their working definition of "severe
maternal morbidity and mortality" included "severe postpartum
hemorrhage (postpartum hemorrhage requiring transfusion), obstetric
shock, sepsis, cardiac complications (cardiac arrest, cardiac failure,
myocardial infarction, and pulmonary embolism), acute renal failure,
obstetric embolism and evacuation of incisional hematoma."
Factors that increase maternal death can be direct or indirect. In a
2009 article on maternal morbidity, the authors said, that generally,
there is a distinction between a direct maternal death that is the
result of a complication of the pregnancy, delivery, or management of
the two, and an indirect maternal death, that is a
pregnancy-related death in a patient with a preexisting or newly
developed health problem unrelated to pregnancy. Fatalities during but
unrelated to a pregnancy are termed accidental, incidental, or
nonobstetrical maternal deaths.
According to a study published in the Lancet which covered the period
from 1990 to 2013, the most common causes are postpartum bleeding
(15%), complications from unsafe abortion (15%), hypertensive
disorders of pregnancy (10%), postpartum infections (8%), and
obstructed labour (6%). Other causes include blood clots (3%) and
pre-existing conditions (28%). Indirect causes are malaria,
anaemia, HIV/AIDS, and cardiovascular disease, all of which may
complicate pregnancy or be aggravated by it.
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, puerperal endometritis, operative
vaginal delivery, episiotomy, low birth weight, preterm delivery, and
small-for-gestational-age infants, all of which can lead to maternal
death. Structural support and family support influences 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.
Unsafe abortion is another major cause of maternal death. According to
World Health Organization
World Health Organization in 2009, every eight minutes a woman
died from complications arising from unsafe abortions. Complications
include hemorrhage, infection, sepsis and genital trauma.
By 2007, globally, preventable deaths from improperly performed
procedures constitute 13% of maternal mortality, and 25% or more in
some countries where maternal mortality from other causes is
relatively low, making unsafe abortion the leading single cause of
maternal mortality worldwide.
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
Maternal mortality ratio
Maternal mortality ratio (MMR): 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): the number of maternal deaths in a
population divided by the number of women of reproductive age, usually
expressed per 1,000 women.
Lifetime risk of maternal death: refers to the probability that a
15-year-old female will die eventually from a maternal cause if she
experiences throughout her lifetime the risks of maternal death and
the overall levels of fertility and mortality that are observed for a
given population. The adult lifetime risk of maternal mortality can be
derived using either the maternal mortality ratio (MMR), or the
maternal mortality rate (MMRate). 
Proportion of maternal deaths among deaths of women of reproductive
age (PM): 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 includes civil registration
system, household surveys, census, reproductive age mortality studies
(RAMOS) and verbal autopsies.
According to the 2010
United Nations Population Fund
United Nations Population Fund report,
developing nations account for ninety-nine percent of maternal deaths
with the majority of those deaths occurring in Sub-Saharan Africa and
Southern Asia. Globally, high and middle income countries
experience lower maternal deaths than low income countries. The Human
Development Index (HDI) accounts for between 82 and 85 percent of the
maternal mortality rates among countries. In most cases, high
rates of maternal deaths occur in the same countries that have high
rates of infant mortality. These trends are a reflection that higher
income countries have stronger healthcare infrastructure, medical and
healthcare personnel, use more advanced medical technologies and have
fewer barriers to accessing care than low income countries. Therefore,
in low income countries, the most common cause of maternal death is
obstetrical hemorrhage, followed by hypertensive disorders of
pregnancy, in contrast to high income countries, for which the most
common cause is thromboembolism.
At a country level,
India (19% or 56,000) and
Nigeria (14% or 40,000)
accounted for roughly one third of the maternal deaths in
2010. Democratic Republic of the Congo, Pakistan,
Sudan, Indonesia, Ethiopia, United Republic of Tanzania, Bangladesh
Afghanistan comprised between 3 and 5 percent of maternal deaths
each. These ten countries combined accounted for 60% of all the
maternal deaths in 2010 according to the United Nations Population
Fund report. Countries with the lowest maternal deaths were Estonia,
Greece and Singapore.
Until the early 20th century developed and developing countries had
similar rates of maternal mortality. Since most maternal deaths
and injuries are preventable, they have been largely eradicated in
the developed world.
A lot of progress has been made since the United Nations made the
reduction of maternal mortality part of the Millennium Development
Goals (MDGs). Bangladesh, for example, cut the number of deaths per
live births by almost two thirds from 1990 to 2015. However, the MDG
was to reduce it by 75%. According to government data, the figure for
2015 was 181 maternal deaths per 100,000 births. The MDG mark was 143
per 100,000. A further reduction of maternal mortality is now part
of the Agenda 2030 for sustainable development.The target of the third
Sustainable Development Goal
Sustainable Development Goal (SDG) is to reduce the global maternal
mortality rate (MMR) to less than 70 per 100,000 live births by 2030.
Variation within countries
There are significant maternal mortality intracountry variations,
especially in nations with large equality gaps in income and education
and high healthcare disparities. Women living in rural areas
experience higher maternal mortality than women living in urban and
sub-urban centers because those living in wealthier households,
having higher education, or living in urban areas, have higher use of
healthcare services than their poorer, less-educated, or rural
counterparts. There are also racial and ethnic disparities in
maternal health outcomes which increases maternal mortality in
Maternal mortality in the United States
Main article: Maternal mortality in the United States
The U.S. has the "highest rate of maternal mortality in the
industrialized world." In the United States, the maternal death
rate averaged 9.1 maternal deaths per 100,000 live births during the
years 1979–1986, but then rose rapidly to 14 per 100,000 in 2000
and 17.8 per 100,000 in 2009. In 2013 the rate was 18.5 deaths per
100,000 live births, with some 800 maternal deaths reported. It
has been suggested that the rise in maternal death in the United
States may be due to improved identification and misclassification
resulting in false positives.
NPR investigated factors that led to the
increase in maternal mortality in the United States. They reported
that the "rate of life-threatening complications for new mothers in
the U.S. has more than doubled in two decades due to pre-existing
conditions, medical errors and unequal access to care." According
to the Centers for Disease Control and Prevention, c. 4 million women
who give birth in the US annually, over 50,000 a year, experience
"dangerous and even life-threatening complications." Of those 700
to 900 die every year "related to pregnancy and childbirth."
According to a report by the
United States Centers for Disease Control
and Prevention, in 1993 the rate of Severe Maternal Morbidity, rose
from 49.5 to 144 "per 10,000 delivery hospitalizations" in 2014, an
increase of almost 200 percent.
Blood transfusions also increased
during the same period with "from 24.5 in 1993 to 122.3 in 2014 and
are considered to be the major driver of the increase in SMM. After
excluding blood transfusions, the rate of SMM increased by about 20%
over time, from 28.6 in 1993 to 35.0 in 2014."
The death rate for women giving birth plummeted in the twentieth
century. The historical level of maternal deaths is probably around 1
in 100 births. Mortality rates reached very high levels in
maternity institutions in the 1800s, sometimes climbing to 40 percent
of patients (see Historical mortality rates of puerperal fever). At
the beginning of the 1900s, maternal death rates were around 1 in 100
for live births. Currently, there are an estimated 275,000 maternal
deaths each year. Public health, technological and policy
approaches are steps that can be taken to drastically reduce the
global maternal death burden.
Four elements are essential to maternal death prevention, according to
UNFPA. First, prenatal care. It is recommended that expectant
mothers receive at least four antenatal visits to check and monitor
the health of mother and fetus. Second, skilled birth attendance with
emergency backup such as doctors, nurses and midwives who have the
skills to manage normal deliveries and recognize the onset of
complications. Third, emergency obstetric care to address the major
causes of maternal death which are hemorrhage, sepsis, unsafe
abortion, hypertensive disorders and obstructed labour. Lastly,
postnatal care which is the six weeks following delivery. During this
time bleeding, sepsis and hypertensive disorders can occur and
newborns are extremely vulnerable in the immediate aftermath of birth.
Therefore, follow-up visits by a health worker to assess the health of
both mother and child in the postnatal period is strongly recommended.
Death Surveillance and Response is another strategy that has
been used to prevent maternal death . This is one of the interventions
proposed to reduce maternal mortality where maternal l deaths are
continuously reviewed to learn the causes and factors that led to the
death. The information from the reviews is used to make
recommendations for action to prevent future similar deaths.
Maternal and perinatal death reviews have been in practice for a long
time worldwide and the
World Health Organization
World Health Organization (WHO) introduced the
Maternal and Perinatal
Death Surveillance and Response (MPDSR) with a
guideline in 2013. Studies have shown that acting on recommendations
from MPDSR can reduce maternal and perinatal mortality by improving
quality of care in the community and health facilities.
The decline in maternal deaths has been due largely to improved
asepsis, fluid management and blood transfusion, and better prenatal
Technologies have been designed for resource poor settings that have
been effective in reducing maternal deaths as well. The non-pneumatic
anti-shock garment is a low-technology pressure device that decreases
blood loss, restores vital signs and helps buy time in delay of women
receiving adequate emergency care during obstetric hemorrhage. It
has proven to be a valuable resource. Condoms used as uterine
tamponades have also been effective in stopping post-partum
On 27 April 2010 Sierra Leone launched free healthcare for pregnant
and breastfeeding women
Most maternal deaths are avoidable, as the health-care solutions to
prevent or manage complications are well known. Improving access to
antenatal care in pregnancy, skilled care during childbirth, and care
and support in the weeks after childbirth will reduce maternal deaths
significantly. It is particularly important that all
births be attended by skilled health professionals, as timely
management and treatment can make the difference between life and
death. To improve maternal health, barriers that limit access to
quality maternal health services must be identified and addressed at
all levels of the health system. Recommendations for reducing
maternal mortality include access to health care, access to family
planning services, and emergency obstetric care, funding and
intrapartum care. Reduction in unnecessary obstetric surgery has
also been suggested.
Family planning approaches include avoiding pregnancy at too young of
an age or too old of an age and spacing births. Access to primary care
for women even before they become pregnant is essential along with
access to contraceptives.
The biggest global policy initiative for maternal health came from the
United Nations' Millennium Declaration which created the
Millennium Development Goals. The fifth goal of the United Nations'
Millennium Development Goals
Millennium Development Goals (MDGs) initiative is to reduce the
maternal mortality rate by three quarters between 1990 and 2015 and to
achieve universal access to reproductive health by 2015.
Millennium Development Goals
Millennium Development Goals (MDGs) are eight international
development goals that were officially established following the
Millennium Summit of the United Nations in 2000.
Trends through 2010 can be viewed in a report written jointly by the
WHO, UNICEF, UNFPA, and the World Bank.
Countries and local governments have taken political steps in reducing
maternal deaths. Researchers at the Overseas Development Institute
studied maternal health systems in four apparently similar countries:
Rwanda, Malawi, Niger, and Uganda. In comparison to the other
Rwanda has an excellent recent record of improving
maternal death rates. Based on their investigation of these varying
country case studies, the researchers conclude that improving maternal
health depends on three key factors: 1. reviewing all maternal
health-related policies frequently to ensure that they are internally
coherent; 2. enforcing standards on providers of maternal health
services; 3. any local solutions to problems discovered should be
promoted, not discouraged.
In terms of aid policy, proportionally, aid given to improve maternal
mortality rates has shrunken as other public health issues, such as
HIV/AIDS, have become major international concerns. Maternal
health aid contributions tend to be lumped together with newborn and
child health, so it is difficult to assess how much aid is given
directly to maternal health to help lower the rates of maternal
mortality. Regardless, there has been progress in reducing maternal
mortality rates internationally.
Maternal deaths and disabilities are leading contributors in women's
disease burden with an estimated 275,000 women killed each year in
childbirth and pregnancy worldwide. In 2011, there were
approximately 273,500 maternal deaths (uncertainty range, 256,300 to
291,700). Forty-five percent of postpartum deaths occur within 24
hours. Ninety-nine percent of maternal deaths occur in developing
Maternal mortality rate per 100,000 live births. 2015.
Confidential Enquiry into Maternal Deaths in the UK
List of women who died in childbirth
Maternal mortality in fiction
Maternal near miss
^ a b "Health statistics and information systems: Maternal mortality
ratio (per 100 000 live births)". World Health Organization. Retrieved
June 17, 2016.
^ Maternal Mortality Ratio vs Maternal Mortality Rate on Population
Research Institute website
^ a b c d e f g "Maternal health". United Nations Population Fund.
^ a b GBD 2013 Mortality and Causes of
Death (17 December 2014).
"Global, regional, and national age-sex specific all-cause and
cause-specific mortality for 240 causes of death, 1990-2013: a
systematic analysis for the Global Burden of Disease Study 2013".
Lancet. 385 (9963): 117–71. doi:10.1016/S0140-6736(14)61682-2.
PMC 4340604 . PMID 25530442.
^ a b AbouZahr, Carla (December 1, 2003). "Global burden of maternal
death and disability". British Medical Bulletin. 67 (1): 1–11.
doi:10.1093/bmb/ldg015. Retrieved December 23, 2017.
^ Maternal Mortality Estimates developed by WHO, UNICEF and UNFPA.
Geneva, World Health Organization, 2004.
^ a b c Kilpatrick, Sarah K.; Ecker, Jeffrey L. (2016). "Severe
maternal morbidity: screening and review" (PDF). American College of
Obstetricians and Gynecologists and the Society for Maternal–Fetal
Medicine. Washington, DC. 215: B17–B22.
doi:10.1016/j.ajog.2016.07.050. Cited in CDC 2017 report.
^ Muraca, GiuliaM.; Sabr, Yasser; Lisonkova, Sarka; Skoll, Amanda;
Brant, Rollin; Cundiff, Geoffrey W.; Joseph, K.S. (June 5, 2017).
"Perinatal and maternal morbidity and mortality after attempted
operative vaginal delivery at midpelvic station". Canadian Medical
Association Journal (CMAJ). Canadian Medical Association. 189 (22):
E764–E772. doi:10.1503/cmaj.161156. PMC 5461125 .
PMID 28584040. E764–E772
^ Khlat, M. & Ronsmans, C. (2009). "Deaths Attributable to
Childbearing in Matlab, Bangladesh: Indirect Causes of Maternal
Mortality Questioned". American Journal of Epidemiology. 151 (3):
^ a b "Maternal mortality: Fact sheet N°348". World Health
Organization. WHO. Retrieved 20 June 2014.
^ The most common causes of anemia/anaemia are poor nutrition, iron,
and other micronutrient deficiencies, which are in addition to
malaria, hookworm, and schistosomiasis (2005
WHO report p45).
^ "Maternal mortality". World Health Organisation.
^ a b Conde-Agudelo A, Belizan JM, Lammers C (2004).
"Maternal-perinatal morbidity and mortality associated with adolescent
pregnancy in Latin America: Cross-sectional study". American Journal
Obstetrics and Gynecology. 192 (2): 342–349.
doi:10.1016/j.ajog.2004.10.593. PMID 15695970.
^ Morgan, K. J. & Eastwood, J. G. (2014). "Social determinants of
maternal self-rated health in South Western Sydney, Australia". BMC
Research Notes. 7 (1): 1–12. doi:10.1186/1756-0500-7-51.
PMC 3899616 . PMID 24447371.
^ Haddad, L. B. & Nour, N. M. (2009). "Unsafe abortion:
unnecessary maternal mortality". Reviews in obstetrics and gynecology.
2 (2): 122–6. PMC 2709326 . PMID 19609407.
^ Dixon-Mueller, Ruth; Germain, Adrienne (1 January 2007). "Fertility
Regulation and Reproductive Health in the Millennium Development
Goals: The Search for a Perfect Indicator". Am J Public Health. 97
(1): 45–51. doi:10.2105/AJPH.2005.068056. PMC 1716248 .
^ a b c "MME Info". maternalmortalitydata.org. Archived from the
original on October 14, 2013.
^ a b c d [UNICEF, W. (2012). UNFPA, World Bank (2012) Trends in
maternal mortality: 1990 to 2010. WHO, UNICEF.]
^ Lee, K. S.; Park, S. C.; Khoshnood, B.; Hsieh, H. L. &
Mittendorf, R. (1997). "Human development index as a predictor of
infant and maternal mortality rates". The Journal of Pediatrics. 131
(3): 430–433. doi:10.1016/S0022-3476(97)80070-4.
^ Venös tromboembolism (VTE) - Guidelines for treatment in C
counties. Bengt Wahlström, Emergency department, Uppsala Academic
Hospital. January 2008
^ "Comparison: Maternal Mortality Rate". The World Factbook. Central
^ De Brouwere V, Tonglet R, Van Lerberghe W (October 1998).
"Strategies for reducing maternal mortality in developing countries:
what can we learn from the history of the industrialized West?". Trop.
Med. Int. Health. 3 (10): 771–82.
doi:10.1046/j.1365-3156.1998.00310.x. PMID 9809910.
^ Manzur Kadir Ahmed (3 September 2017). "Why paramedics and midwives
matter". D+C, development and cooperation. Retrieved 5 October
WHO Maternal Health". WHO.
^ Wang W, Alva S, Wang S, Fort A (2011). "Levels and trends in the use
of maternal health services in developing countries" (PDF). Calverton,
MD: ICF Macro. p. 85. (DHS Comparative Reports 26).
^ Lu, M. C. & Halfon, N. (2003). "Racial and ethnic disparities in
birth outcomes: a life-course perspective". Maternal and child health
journal. 7 (1): 13–30. doi:10.1023/A:1022537516969.
^ a b c Ellison, Katherine; Martin, Nina (December 22, 2017). "Severe
Complications for Women During
Childbirth Are Skyrocketing — and
Could Often Be Prevented". Lost mothers. ProPublica. Retrieved
December 22, 2017.
^ Atrash HK, Koonin LM, Lawson HW, Franks AL, Smith JC (1990).
"Maternal Mortality in the United States".
Obstetrics and Gynecology.
Centers for Disease Control. 76 (6): 1055–1060.
Pregnancy Mortality Surveillance System -
Pregnancy - Reproductive
^ Morello, Carol (May 2, 2014). "Maternal deaths in childbirth rise in
the U.S." Washington Post.
^ "CDC Public Health Grand Rounds" (PDF). Retrieved 2017-12-26.
^ "Severe Maternal
Morbidity in the United States". Atlanta, Georgia.
Centers for Disease Control and Prevention. November 27, 2017.
Retrieved December 21, 2017. Division of Reproductive Health,
National Center for Chronic Disease Prevention and Health Promotion,
U.S. Department of Health & Human Services.
^ See, for instance, mortality rates at the Dublin Maternity Hospital
^ a b Marge Koblinsky; Mahbub Elahi Chowdhury; Allisyn Moran; Carine
Ronsmans (2012). "Maternal
Morbidity and Disability and Their
Consequences: Neglected Agenda in Maternal Health". J Health Popul
Nutr. 30 (2): 124–130. doi:10.3329/jhpn.v30i2.11294.
JSTOR 23500057. PMC 3397324 . PMID 22838155.
World Health Organization
World Health Organization and partner organizations (2013). Maternal
death surveillance and response: technical guidance. Information for
action to prevent maternal death. World Health Organization, 20 Avenue
Appia, 1211 Geneva 27, Switzerland:
WHO press. p. 128.
ISBN 978 92 4 150608 3. Retrieved 4 October 2017.
^ S. Miller; J. M. Turan; K. Dau; M. Fathalla; M. Mourad; T.
Sutherland; S. Hamza; F. Lester; E. B. Gibson; R. Gipson; et al.
(2007). "Use of the non-pneumatic anti-shock garment (NASG) to reduce
blood loss and time to recovery from shock for women with obstetric
haemorrhage in Egypt". Glob Public Health. 2 (2): 110–124.
doi:10.1080/17441690601012536. PMID 19280394. (NASG)
^ Sayeba Akhter; FCPS; DRH; FICMCH; et al. (2003). "Use of a Condom to
Control Massive Postpartum Hemorrhage" (PDF). Medscape general
medicine. 5 (3): 38.
^ "Reducing Maternal Mortality" (PDF). UNFPA. Retrieved September 1,
^ Costello, A; Azad K; Barnett S (2006). "An alternative study to
reduce maternal mortality". The Lancet. 368 (9546): 1477–1479.
^ "MDG 5: improve maternal health". WHO. May 2015. Retrieved September
^ "Trends in Maternal Mortality: 1990 to 2010" (PDF). WHO, UNICEF,
UNFPA, and the World bank. Retrieved 22 April 2014.
^ Chambers, V.; Booth, D. (2012). "Delivering maternal health: why is
Rwanda doing better than Malawi,
Niger and Uganda?" (Briefing Paper).
Overseas Development Institute.
^ "Development assistance for health by health focus area (Global),
1990-2009, interactive treemap". Institute for Health Metrics and
Evaluation. Archived from the original on 2014-03-17.
^ "Progress in maternal and child mortality by country, age, and year
(Global), 1990-2011". Archived from the original on 2014-03-17.
^ Bhutta, Z. A.; Black, R. E. (2013). "Global Maternal, Newborn, and
Child Health — So Near and Yet So Far". New England Journal of
Medicine. 369 (23): 2226–2235. doi:10.1056/NEJMra1111853.
^ Nour NM (2008). "An Introduction to Maternal Mortality". Reviews in
Ob Gyn. 1 (2): 77–81. PMC 2505173 . PMID 18769668.
^ Global, regional, and national levels of maternal mortality,
1990–2015: a systematic analysis for the Global Burden of Disease
Study 2015. October 8, 2016. The Lancet. Volume 388. 1775–1812. See
table of countries on page 1784 of the PDF.
^ What’s killing America’s new mothers? By Annalisa Merelli.
October 29, 2017. Quartz. "The dire state of US data collection on
maternal health and mortality is also distressing. Until the early
1990s, death certificates did not note if a woman was pregnant or had
recently given birth when she died. It took until 2017 for all US
states to add that check box to their death certificates."
World Health Organization
World Health Organization (2014). Trends in maternal mortality: 1990
to 2013 (PDF). WHO. ISBN 978 92 4 150722 6. Retrieved 2 August
Maternal Mortality in Central Asia, Central Asia Health Review (CAHR),
2 June 2008.
The World Health Report 2005 – Make Every Mother and Child Count
Confidential Enquiry into Maternal and Child Health (CEMACH) - UK
triennial enquiry into "Why Mothers Die"
Reducing Maternal Mortality in Developing Countries - Video,
presentations, and summary of event held at the Woodrow Wilson
International Center for Scholars, March 2008
Birth of a Surgeon PBS documentary about midwives trained in surgical
techniques in Mozambique
Save A Mother Non-profit focused on MMR reduction.
W4 Non-profit that supports mothers and their children to reduce
maternal and infant mortality through safe births.
The Global Library of Women's Medicine Safer Motherhood Section -
non-profit offering freely downloadable material for healthcare
Maternal Mortality in the U.S. Merck for Mothers
Pathology of pregnancy, childbirth and the puerperium (O, 630–679)
Oedema, proteinuria and
related to pregnancy
Acute fatty liver of pregnancy
Intrahepatic cholestasis of pregnancy
Integumentary system /
dermatoses of pregnancy
Intrahepatic cholestasis of pregnancy
Pruritic folliculitis of pregnancy
Pruritic urticarial papules and plaques of pregnancy
Pruritic urticarial papules and plaques of pregnancy (PUPPP)
Maternal care related to the
fetus and amniotic cavity
Braxton Hicks contractions
chorion / amnion
Amniotic band syndrome
Premature rupture of membranes
Twin-to-twin transfusion syndrome
Amniotic fluid embolism
Pain management during childbirth
Umbilical cord prolapse
Low milk supply
Diastasis symphysis pubis
Systemic lupus erythematosus
Sexual activity during pregnancy
Temporal lobe necrosis
Programmed cell death
Immunogenic cell death
Ischemic cell death
Death by natural causes
Medical definition of death
Causes of death by rate
Expressions related to death
People by cause of death
Preventable causes of death
Notable deaths by year
TV actors who died during production
Gompertz–Makeham law of mortality
Maternal mortality in fiction
Burial at sea
Beating heart cadaver
Taboo on the dead
Cause of death
Declared death in absentia
Prohibition of death
Right to die
Death and culture
Personification of death
Death from laughter
Festival of the Dead
Fascination with death
Museum of Death
The Order of the Good Death