Maternal deaths on the American continent

Maternal deaths on the American continent

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Maternal deaths on the American continent

Maternal deaths on the American continent

Image Source: PlosONE A new study published in the open access scientific journal PLoSONE has shown that the maternal mortality rate (MMR) in Chile has dramatically reduced over the last 50 years and now compares favourably with the rest of the American continent. Study figures suggest the rate now surpasses that of most regional countries including that of the US. OFFICIAL PRESS RELEASE "Concepción, Chile, May 5 - A scientific analysis of 50 years of maternal mortality data from Chile has found that the most important factor in reducing maternal mortality is the educational level of women. “Educating women enhances women’s ability to access existing health care resources, including skilled attendants for childbirth, and directly leads to a reduction in her risk of dying during pregnancy and childbirth,” according to Dr Elard Koch, epidemiologist and leading author of the study. The research entitled “Women’s Education Level, Maternal Health Facilities, Abortion Legislation and Maternal Deaths: a Natural Experiment in Chile from 1957 to 2007” was conducted on behalf of the Chilean Maternal Mortality Research Initiative (CMMRI) and published in the Friday, May 4 issue of PLoS ONE. Using 50 years of official data from Chile’s National Institute of Statistic (1957-2007), the authors looked at factors likely to affect maternal mortality, such as years of education, per capita income, total fertility rate, birth order, clean water supply, sanitary sewer, and childbirth delivery by skilled attendants. They also analysed the effect of historical educational and maternal health policies, including legislation that has prohibited abortion in Chile since 1989, on maternal mortality. During the fifty-year study period, the overall Maternal Mortality Ratio or MMR (the number of maternal deaths related to childbearing divided by the number of live births) dramatically declined by 93.8%, from 270.7 to 18.2 deaths per 100,000 live births between 1957 and 2007, making Chile a paragon for maternal health in other countries. “In fact, during 2008, the overall MMR declined again, to 16.5 per 100,000 live births, positioning Chile as the country with the second lowest MMR in the American continent after Canada and with at least two points lower MMR than the United States” said Koch. One of the most significant findings is that, contrary to widely held assumptions, making abortion illegal in Chile did not result in an increase in maternal mortality. In fact, after abortion was made illegal in 1989, the MMR continued to decrease from 41.3 to 12.7 per 100,000 live births (69.2% reduction). “Definitively, the legal prohibition of abortion is unrelated to overall maternal mortality rates” emphasized Koch. The variables affecting this decrease included the predictable factors of delivery by skilled attendants, complementary nutrition for pregnant women and their children in the primary care clinics and schools, clean facilities, and fertility. But the most important factor and the one that increased the effect of all others was the educational level of women. For every additional year of maternal education there was a corresponding decrease in the MMR of 29.3 per 100,000 live births. The picture for Chile includes a transition of leading causes of death along with an accelerated decline of fertility and delayed motherhood. Koch explained that direct causes –those directly attributable to pregnancy condition– were the rule before 1990, but from then, indirect causes –i.e. non-obstetric chronic conditions such as hypertension and diabetes among others– arise as the most prevalent, hindering the decline on maternal mortality. “This study uncovers an on-going ‘fertility paradox’ in maternal health: education is the major modulator that has helped Chile to reach one of the safest motherhood in the world, but also contributes to decrease fertility, excessively delaying motherhood and putting mothers at risk because of their older age.” Thus, an emerging problem nowadays “is not a question of how many children a mother has, but a question of when a mother has her children, specially the first of them” concluded Koch." Read the thoughts of Professor Koch here: http://bit.ly/KPR1GK

  Article Info
Created: May 9 2012 at 02:10:48 PM
Updated: May 9 2012 at 02:14:40 PM
Category: Medicine
Language: English

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