Maternal Mortality

The purpose of this paper is to summarise the article, “Too far, too little, too late: a community-based case-control study of maternal mortality in rural west Maharashtra, India”. It is based on maternal mortality, which has become a sensitive issue across the world. The study has been carried out with the help of various cases through a great number of health institutions, followed by multivariate analysis. This has helped in understanding the dependent and independent variables.

Safe Motherhood Initiative (SMI) in Nairobi in 1987 and the World Summit for Children in 1990 focused on maternal mortality as a neglected tragedy. Unlike other health issues, pregnancy-related problems cannot be predicted. However, they can be treated. Therefore,

Studies took place in private hospitals, district hospitals and teaching hospitals. Case studies were chosen on the basis of factors such as incompleteness of official vital registration data, departure from study due to traditional methods of delivery at the woman's parental home, the problems involved in many such home deliveries, and the logistics of covering the vast geographical area with limited resources and a research team of just four persons. The maternal deaths occurring between 15 and 45 years of age were noted from medical and societal institutions. The study included the determination of pregnancy-related and maternal deaths, in which the ICD-10 definition of ‘maternal death’ was used. The controls were derived from the population from which the cases belonged. During the study, the pregnant women were classified as those with normal pregnancies and serious pregnancy-related problems. Each maternal death was matched on the basis of complication-matched control and geographical control. Data was systematically collected by taking patient’s history from the husband as well as the woman’s own family. Later, the living newborns from the maternal deaths were also examined. A group of doctors identified the cause of deaths and their preventions. Softwares like SPSS and MULTLR were used and various models

Similar results were seen in the comparison of deaths with complicated-matched controls. In addition to this, it was observed that the local tradition of living with the woman’s mother during the pregnancy period and the presence of trained nurses nearby reduced complications. On the other hand, lack of immediate medical facilities and high number of referrals before reaching appropriate care increased the frequency of deaths. The relation of these factors and disease-related complications was analysed.

In the expert panel’s opinion, difficulties in transport and money facilities, inefficient medical services in hospitals and lack of blood and drugs supply accounted for maternal deaths, in ascending order of their contribution. There is a strong link between maternal care and infant mortality. The various health statuses of babies from maternal deaths were compared to that of normal pregnancies. Here, there was no difference in the statistics between male and female