Maternal Mortality or Maternal Death:
A maternal death refers to a female death from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy.
Measurement requires information on pregnancy status, timing of death (during pregnancy, childbirth, or within 42 days of termination of pregnancy), and cause of death.
It is important to note that not all deaths which occur temporally to pregnancy are considered "maternal deaths". Maternal deaths are a specific subset of deaths which occur during pregnancy, childbirth and the puerperium and can be further divided into two groups, namely direct and indirect obstetric deaths.
Direct obstetric deaths result from obstetric complications of the pregnant state (pregnancy, labour and puerperium); from interventions, omissions or direct treatment; or from a chain of events resulting in any of these.
Indirect deaths result from previously existing disease or disease that developed during pregnancy and was not directly due to obstetric causes but was aggravated by the physiologic effects of pregnancy.
Deaths which do not meet these criteria, such as those which occur as a result of accidents, are defined by the more general term, "death occurring in pregnancy, childbirth or the puerperium" (previously referred to as "pregnancy related deaths").
The maternal mortality ratio should not be confused with the maternal mortality rate (the number of maternal deaths in a population divided by the number of women of reproductive age). The maternal mortality rate captures the likelihood of both becoming pregnant and dying during pregnancy or the puerperium (six weeks after delivery).
Maternal Mortality Ratio
The 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 maternal mortality ratio can be calculated by dividing recorded (or estimated) number of maternal deaths by total recorded (or estimated) number of live births in the same period and multiplying by 100,000.
Maternal Mortality Rate
The maternal mortality ratio should not be confused with the maternal mortality rate (the number of maternal deaths in a population divided by the number of women of reproductive age). The maternal mortality rate captures the likelihood of both becoming pregnant and dying during pregnancy or the puerperium (six weeks after delivery).
Maternal Death Rate
From DOH
MATERNAL DEATH RATE = Total no. of direct maternal deaths for a period divided by total no. of maternal (obstetrical) discharges (including deaths) for the period and then multiplied by 100.
ROJoson's Notes:
Focus on tracking maternal deaths (see WHO definition) whether in hospitals, birthing facilities, and RHU.
Classify them into:
Direct Obstetrical Death
Indirect Obstetrical Death
Death Occurring During Pregnancy (not direct or indirect)
Target: Focus on Direct Obstetrical Death - Target NEAR ZERO number of death (0-1) or 0 to less than 1% of maternal death rate
ZCMC data for 2014:
Total number of obstetric discharges = 6869 patients
Total number of maternal deaths from direct causes = 21
Maternal Death Rate =0.3%
References:
http://mdgs.un.org/unsd/mdg/Metadata.aspx?IndicatorId=0&SeriesId=553
DOH
ROJ@15mar11