Saving Mothers: Report on the Confidential Enquiries into Maternal Deaths in South Africa

Abstract

In 1952 the Maternal Mortality Ratio (MMR), excluding early pregnancy deaths, was 54/100 000 births for England andWales. This was the first year of the Confidential Enquiry in Maternal Deaths in England and Wales. fn the triennium,1994-1996 the MMR for the United Kingdom was 12.2/100 000 maternities. It is estimated that the MMR for South Africa is about 150/100 000 live births. Clearly the approximately twelve times higher MMR in South Africa is not due to a global lack of knowledge on how to manage severely ill pregnant women, bur due to maternity services in SouthAfrica not implementing available knowledge. There may be many reasons for this, medical education, availability of resources and socio-economic problems immediately spring to mind. The establishment of the Confidential Enquiry into Maternal Deaths in South Africa allows us to determine at what level there is a breakdown in the health system and in turn this will allow for remedial action. Information for "saving Mothers" comes from an analysis of data on women who died in South Africa during pregnancy, Iabour or the puerperium during 1998 and were reported to the National Committee on Confidential Enquiries into Maternal Deaths (NCCEMD).