Thankfully, maternal deaths are rare in Australia. But the latest Australian Institute of Health and Welfare (AIHW) report Maternal deaths in Australia 2015-2017 show that, tragically, healthy women do still die during pregnancy and following birth.
The maternal death cases we have handled for families demonstrate that often those deaths are preventable. The report notes that an analysis of contributory factors to maternal deaths suggests that up to one-third might be avoidable (CCOPMM 2019; Farquhar et al. 2011).
What is a Maternal Death?
The AIHW consistently defines maternal death as “the death of a woman while pregnant or within 42 days of the end of pregnancy, irrespective of the duration and outcome of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.”
Latest AIHW Maternal Deaths Report Findings
In the triennium 2015–2017:
- 915,610 women gave birth in Australia
- 59 deaths were classified as directly or indirectly related to pregnancy
- the maternal mortality ratio (MMR) was 6.4 deaths per 100,000 women giving birth, which is the second lowest MMR reported in any triennium in Australia
- 12 deaths were classified as coincidental to pregnancy. 1 death was still awaiting classification at time of publication.
Indigenous and regional Australian women at greater risk of maternal death
The MMR of Aboriginal and Torres Strait Islander women in Australia is approximately three times higher than that of non-Indigenous women giving birth.
Almost two-thirds (64%) of the women who died lived in major cities, and this group had the lowest MMR (5.8 per 100,000 women giving birth). Women who lived in regional areas had an MMR of 7.8, and those in remote and very remote areas had an MMR of 19.4.
The World Health Organisation (WHO) estimates that, worldwide, 300,000 women die each year from complications of pregnancy and childbirth (WHO 2015).
Australia’s MMR is better than that of New Zealand, United Kingdom and in the United States of America. Only a few countries report better maternal mortality rates. The benchmark has been set by Greece, Finland, Poland and Iceland who report the lowest maternal mortality rates in the world of approximately three deaths per 100,000 women giving birth. These rates are half those of Australia so there is more work to be done locally.
Common causes of Australian maternal deaths during 2015–2017
The common causes of maternal death are suicide, cardiovascular disease and sepsis.
The MMR continues to be higher among women who:
- identified as being Aboriginal or Torres Strait Islander
- were aged 35 and over (more than 1 in 3 maternal deaths (about 37%) an MMR 10.5 per 100,000)
- had a body mass index (BMI) of 30 or more
- had given birth 4 or more times
- smoked in the first 20 weeks of pregnancy.
AIHW notes that caution should be used when interpreting these data, due to the small number of maternal deaths in Australia, and even smaller numbers when these deaths are broken down by characteristics.
Preventing maternal deaths
The AIHW report is useful to identify trends in maternal mortality and develop an evidence base for maternal deaths to inform maternity services policy and practice. The AIHW Maternal deaths in Australia series provides 53 years of continuous maternal mortality data in Australia.
An article in the Medical Journal of Australia (MJA) states that Australian maternal mortality rates have dropped significantly from a reported high of approximately 41 deaths per 100,000 women in 1964.
The author of that article says the genesis of the almost sixfold reduction in maternal death rates in Australia is multifactorial, including the improved general health of the population and the availability of better health care options, such as antibiotics, blood transfusion, safer anaesthesia and effective diagnostic ultrasound. The liberalisation of abortion is likely also reflected by these positive figures.
Taking legal action for maternal deaths
Taking legal action is another useful tool to prevent further maternal deaths in Australia. The maternal death cases we have handled, and others we have reviewed, shine a light on practices, negligent or otherwise, that contributed to a women’s death. Legal action can force or highlight the need for changes to policies and procedures to prevent future deaths.
If you are concerned that a loved one may have suffered an avoidable maternal death, our caring and experienced health law team can discuss the options open to you for justice or compensation. Contact us today.