Maternal Mortality: Risk Factors, Anthropological Perspectives, Prevalence in Developing Countries and Preventive Strategies for Pregnancy-Related Deaths


David A. Schwartz, MD (Editor)
Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Series: Pregnancy and Infants: Medical, Psychological and Social Issues
BISAC: SOC036000

Pregnancy is a life-threatening event in many parts of the developing world. Globally, it is estimated that 289,000 women died from being pregnant in 2013. The lifetime risk for dying as a result of pregnancy is as high as 1 in 6 for women living in the poorest nations of the world. Ninety-nine percent of all maternal deaths occur in resource-poor nations, averaging 800 deaths each day or 33 per hour. Improvement in maternal mortality was addressed by the United Nations in 1990 by the Millennium Development Goals (MDG’s) in which the 5th goal was global reduction of this statistic by three-quarters by the year 2015. However, this goal will not be achieved.

For every mother that dies from pregnancy in resource-poor countries, 15 to 30 additional women develop serious damage. This textbook addresses the continuing problem of maternal deaths in developing nations from three perspectives: medical, anthropological, and epidemiological. The twenty-eight internationally-respected authors in this textbook have had direct field experience with maternal health and pregnancy complications in resource-poor regions. They provide up-to-date analysis of maternal deaths in the regions of the world most affected by this public health problem.

These locations include Asia, South America, and—most severely affected—Africa.
Prior to this publication, specialists in the fields of obstetrics, epidemiology, and socio-cultural anthropology have rarely shared and combined their insights into maternal death causation and prevention. This book combines the experiences and opinions of:
• anthropologists
• nurses
• midwives
• physicians
• epidemiologists
• staff of national Ministries of Health
• public policy advisers
• members of international organizations

These individuals collaborate to inform the reader of a multi-specialty approach to understand the difficulties of improving maternal mortality in developing nations. These twenty chapters are extensively highlighted with color photographs, tables, charts and maps to illustrate the statistical and geographic aspects of the author’s opinions and experiences. Not only is this the first published textbook to address maternal death in many years; it is the first to examine it by using a combined anthropological-medical-epidemiological approach. This book belongs in libraries of anyone working in the areas of maternal health, pregnancy complications and mortality in developing nations.
(Imprint: Nova)

Table of Contents

Table of Contents

Preface: Interface of Epidemiology, Anthropology and Health Care in Maternal Death Prevention in Resource-Poor Nations

An Index of Terms and Concepts Used in Maternal Death Surveillance and Analysis

The Birth of Safe Motherhood: Global Lessons Learned in the Management and Prevention of Maternal Death in Rich and Poor Nations
(Kylea Laina Liese, Alaska Native Medical Center, Anchorage, Alaska, USA)

The Convergence of Social and Institutional Dynamics Resulting in Maternal Death in Rukwa, Tanzania
(Adrienne E. Strong, Doctoral Candidate, Department of Anthropology, Washington University in St. Louis, St. Louis, Missouri, USA)

Maternal Health Situation in India: Issues and Options
(Kranti Suresh Vora, Poonam Trivedi, Sandul Yasobant, and Dileep V. Mavalanker, Associate Professor, Indian Institute of Public Health, Gandhinagar, India, and others)
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Uterine Rupture as the Cause of Maternal Mortality in Sub-Saharan Africa
(Melisachew Mulatu and Drucilla Jane Roberts, Ayder Referral Hospital
Mekelle University, Mekelle, Ethiopia, and others)

Maternal Mortality and Mental Illness in Developing Countries: A Neglected Challenge
(Sara Gorman, Mailman School of Public Health Columbia University, New York, New York, USA)

Maternal Mortality: Risk Factors, Prevalence and Preventive Strategies in Colombia
(Julián Alberto Herrera Murgueitio and Juan Pablo Herrera-Escobar, Director of WHO Collaborative Center for Research in Human Reproduction, Emeritus Professor of Medicine, Dean of the Faculty of Health, Universidad del Valle, Cali, Colombia, and others)

Food Insecurity, Dietary Challenges, and Their Implications on Maternal Mortality Reduction Strategies in Northern Nigeria
(Henry V. Doctor and Oluwatoni A. Idowu, United Nations Office on Drugs and Crime, and University of Leeds, United Kingdom)

Maternal Mortality in Tibet: Sciences of Healing, Sowa Rigpa and Community Health Workers
(Gabriel Lafitte, Specialist and consultant in Tibetan development and public policy, Australia)

Trends in Maternal Mortality in Morocco: 1960-2010
(Katra-Ennada Darkaoui and Michel Garenne, Ministry of Public Health
Rabat, Morocco, and others)

Maternal Mortality Reduction in Sub-Saharan Africa: A Lingering Dream for the Post-2015 Agenda
(Henry V. Doctor, Integrated Programme and Oversight Branch, Division for Operations, United Nations Office on Drugs and Crime (UNDOC),
Country Office for Nigeria, Abuja, Nigeria)

Three Case Studies and Experiences of Maternal Death at a Regional Referral Hospital in Rukwa, Tanzania
(Samwel J. Marwa and Adrienne E. Strong, Medical Officer in Charge
Sumbawanga Regional Referral Hospital, Sumbawanga, Tanzania, and others)

Pathology of Maternal Death – The Importance of Accurate Autopsy Diagnosis for Epidemiologic Surveillance and Prevention of Maternal Mortality in Developing Countries
(David A. Schwartz, Clinical Professor of Pathology, Georgia Regents University (GRU) – Medical College of Georgia, Augusta, Georgia, USA)

Maternal Suffering and Survivorship in Badakhshan
(Kylea Laina Liese, Alaska Native Medical Center, Anchorage, Alaska, USA)

Does Task Shifting Have a Potential Role in Improving Emergency Obstetric Care (EmOC)?
(Iman Suleiman, Hannah Nathan, and Andrew Shennan, Medical Student
King’s College, London, United Kingdom, and others)

Case Study: Ethiopia’s Effort in Reducing Maternal and Newborn Mortality in the Past Two Decades
(Luwei Pearson and H.E. Kesetebirhan Admasu, Regional Health Advisor for the Eastern and Southern Africa Regional Office of UNICEF,(United Nations Children’s Fund), Nairobi, Kenya, and others)

Maternal Mortality in Indonesia: Anthropological Perspectives on Why Mother Death Defies Simple Solutions
(M. Cameron Hay, Associate Professor of Anthropology, Department of Anthropology, Miami University, Oxford, Ohio, USA)

Strategies to Prevent Maternal, Perinatal and Infant Mortalities in Democratic Republic of Congo: Impact of the Organizational Model of Healthcare
(Abel M. Ntambue, K. Malonga, M. Dramaix-Wilmet, and P. Donnen, École de Santé Publique, Unité d’Epidémiologie et de Santé de la Mère, du Douveau-né et de l’Enfant, Université de Lubumbashi, Lubumbashi, Democratic Republic of Congo, and others)

Unsafe Abortion: A Persistent Cause of Maternal Death and Reproductive Morbidity in Resource-Poor Nations
(David A. Schwartz, Clinical Professor of Pathology, Georgia Regents University (GRU) – Medical College of Georgia, Augusta, Georgia, USA)


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