Lessons from the Past: Maternal Mortality Prevention

Maternal mortality rates were consistently high, greater than one death per 500 pregnancies, in the western world until they made a sharp decline in the 1930s.  The rates experienced today in sub-Saharan Africa averaging 684 deaths per 100,000 live births or one death per 146 pregnancies have not been seen in the western world since the nineteenth century.  Three waves of improvement will be discussed.  The first wave occurred in Europe; the second in the United States; and the third in Asia.  An extensive search and analysis of published literature as well as examination of WHO health indicators by nation are the basis of this presentation.  Recommendations for interventions to prevent maternal mortality will be evaluated based on historical evidence. Historically, maternal mortality has been resistant to reduction despite decreases in other prominent causes of death, infection rates and changes in socioeconomic factors.  Yet there are case studies of nations that demonstrate remarkable declines in maternal mortality in relatively short time spans.  It is evident that provision of quality services to pregnant women during delivery whether it is in the hospital or clinic in more urbanized areas or in homes in rural communities is the key to saving the lives of mothers.  Researchers have concluded that strong political will is necessary to tackle the issue in addition to economic improvements. The lessons of the past can direct the efforts of the present to reach the World Health Organization’s Millennium Development Goal of reducing maternal mortality worldwide by 75% by 2015.