Women worldwide are dying less often in childbirth or soon after delivery for the first time in 40 years, according to a new study in the British medical journal The Lancet. The death rate, which dropped by a total of more than 35%, fell most in the populous countries of India, China, Brazil and Egypt.
In 1980, more than 526,000 women worldwide died during childbirth or complications from it. In 2008, the number was about 343,000. And that’s despite an increase in world population overall.
What is responsible for the decline? A number of factors, experts say. An increase in prenatal care, a decrease in the number of children each woman has, an improvement in the quality of “birth attendants” – doctors or midwives – who attend the births, and a rise in per capita income can all affect the outcome. From the Washington Post:
“Maternal mortality is a key gauge of a population's health and wealth, as well as of women's status. The rate differs greatly between countries and regions, with the best- and worst-performing nations differing by a factor of about 400, according to the Lancet.
“The global rate in 2008 was 251 maternal deaths for every 100,000 live births, according to a research team led by Christopher J.L. Murray at the University of Washington. The highest rate was in Afghanistan (1,575) and the lowest in Italy (4). The United States was 17; Canada, 7; and Mexico, 52.
“More than half of all maternal deaths (about 343,000 in 2008) occurred in six countries, researchers found: India, Nigeria, Pakistan, Afghanistan, Ethiopia and the Democratic Republic of the Congo.
“Between 1980 and 2008, China’s maternal mortality rate fell to 40 from 165; India's to 254 from 677; and Brazil’s to 55 from 149. In many sub-Saharan African countries, a decline that began in the 1980s flattened in the 1990s because of the prevalence of HIV infection, which increases a woman's risk of death during pregnancy and after delivery.”
From the New York Times:
“The overall message, for the first time in a generation, is one of persistent and welcome progress,” the journal’s editor, Dr. Richard Horton, wrote in a comment accompanying the article.
“Dr. Christopher J. L. Murray, the director of the institute for health metrics and evaluation at the University of Washington, in Seattle, and an author of the study, said, “There has been a perception of no progress.”
“But, he said, “some of the policies and programs pursued may be having an effect, as opposed to all that effort with little to show for it.”
“It really is an important positive finding for global health,” he said.
The rate would be even better if it were not for the growing incidence of deaths
from AIDS, the researchers said.
The study in the Lancet was based on more data than was previously available in addition to statistical modeling and was paid for by the Bill & Melinda Gates Foundation.
The Washington Post story:
http://www.washingtonpost.com/wp-dyn/content/article/2010/04/14/AR2010041404974.html
The New York Times story:
http://www.nytimes.com/2010/04/14/health/14births.html
From ABC News:
http://abcnews.go.com/Business/wirestory?id=10373528&page=2
The Lancet article:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60518-1/fulltext