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Maternal mortality in Sweden
Umeå University, Faculty of Medicine, Clinical Sciences, Obstetrics and Gynaecology.
1985 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Every year about half a million women die from complications of pregnancy, parturition and puerperium, most of which are preventable. The purpose of this thesis was to chart the distribution and decline in maternal mortality in Sweden between 1751 and 1980, and furthermore to characterize positive (predisposing) factors and negative (protective) factors of maternal mortality. Maternal mortality declined from 900 to 6.6 per 100,000 live births in these 230 years. Maternal deaths accounted for 10070 of all female deaths in the reproductive ages between 1781 and 1785, but only 0.2.0/0 between 1976 and 1980. However, in the 19th century 40-450/0 of the female deaths in the most active childbearing ages were maternal deaths. The children left motherless had an extremely high mortality. Indirect maternal deaths and puerperal sepsis accounted for the bulk of maternal deaths in the rural areas. Only a minority of maternal deaths occurred in lying-in hospitals. Midwifery services in rural areas and antiseptic techniques were most effective in preventing maternal deaths during the late 19th century. The changing distribution ofage and parity amongst the parturients had a definite impact on the mortality decline, enhanced by time, contributing to 500/0 of the mortality decline over the last 15 years. The expontential decline of cause-specific mortality and case fatality rates during the last 40 years is furthermore explained by the emergence ofmodern medicine - antibiotics, antenatal and obstetric care. The earlier serious problem of illegal abortions was eradicated by legislation and changes in hospital practice. The maternal mortality decline has levelled out during the 1970s, the relative importance of embolism as a cause of death is increasing. Advanced age and intercurrent disease are the most difficult risk factors to overcome. To conclude, this study indicates that the reason why maternal mortality has declined faster than otherhealth indices is that the major part of the maternal deaths can be prevented by medical technology, including family planning, antenatal and obstetric care. This experience should be of interest to developing countries where high rates of maternal mortality prevails.

Place, publisher, year, edition, pages
Umeå: Obstetrik och gynekologi , 1985. , 26 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 156
Keyword [en]
history of medicine, maternal health services, family planning, pregnancy complications, legal and illegal abortions, puerperal infections, embolism, cesarean section, maternal mortality, pregnancy care
Identifiers
URN: urn:nbn:se:umu:diva-1866ISBN: 91-7174-227-1 (print)OAI: oai:DiVA.org:umu-1866DiVA: diva2:142254
Public defence
(English)
Available from: 1985-01-01 Created: 1985-01-01 Last updated: 2010-01-18Bibliographically approved
List of papers
1. Secular trends of maternal mortality in Sweden for the years 1750-1980
Open this publication in new window or tab >>Secular trends of maternal mortality in Sweden for the years 1750-1980
1986 (English)In: Bulletin of the World Health Organization, ISSN 0042-9686, E-ISSN 1564-0604, Vol. 64, no 1, 79-84 p.Article in journal (Refereed) Published
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-3510 (URN)
Available from: 1985-01-01 Created: 1985-01-01 Last updated: 2012-08-10Bibliographically approved
2. The demography of maternal mortality: seven Swedish parishes in the 19th century
Open this publication in new window or tab >>The demography of maternal mortality: seven Swedish parishes in the 19th century
1985 (English)In: International journal of gynaecology and obstetrics, ISSN 0020-7292, Vol. 23, no 6, 489-497 p.Article in journal (Refereed) Published
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-3511 (URN)
Available from: 1985-01-01 Created: 1985-01-01 Last updated: 2012-08-10Bibliographically approved
3. The potential impact of medical technology on maternal mortality in the 19th century
Open this publication in new window or tab >>The potential impact of medical technology on maternal mortality in the 19th century
Article in journal (Refereed) Submitted
Identifiers
urn:nbn:se:umu:diva-3512 (URN)
Available from: 1985-01-01 Created: 1985-01-01Bibliographically approved
4. Age and parity as determinants of maternal mortality: impact of their shifting distribution amongstparturients in Sweden 1780-1980
Open this publication in new window or tab >>Age and parity as determinants of maternal mortality: impact of their shifting distribution amongstparturients in Sweden 1780-1980
1985 (English)In: Bulletin of the World Health Organization, ISSN 0042-9686, E-ISSN 1564-0604, Vol. 64, no 1, 85-91 p.Article in journal (Refereed) Published
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-3513 (URN)
Available from: 1985-01-01 Created: 1985-01-01 Last updated: 2012-08-10Bibliographically approved
5. The decline in maternal mortality in Sweden, 1931-1980
Open this publication in new window or tab >>The decline in maternal mortality in Sweden, 1931-1980
1985 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 64, no 7, 583-592 p.Article in journal (Refereed) Published
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-3514 (URN)
Available from: 1985-01-01 Created: 1985-01-01 Last updated: 2012-08-10Bibliographically approved
6. Maternal deaths related to abortions in Sweden, 1931-1980
Open this publication in new window or tab >>Maternal deaths related to abortions in Sweden, 1931-1980
1985 (English)In: Gynecologic and Obstetric Investigation, ISSN 0378-7346, E-ISSN 1423-002X, Vol. 20, no 4, 169-178 p.Article in journal (Refereed) Published
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-3515 (URN)A1985AWF9100001 ()
Available from: 1985-01-01 Created: 1985-01-01 Last updated: 2014-08-29Bibliographically approved
7. Amniotic fluid embolism in Sweden, 1951-1980
Open this publication in new window or tab >>Amniotic fluid embolism in Sweden, 1951-1980
1985 (English)In: Gynecologic and Obstetric Investigation, ISSN 0378-7346, E-ISSN 1423-002X, Vol. 20, no 3, 130-137 p.Article in journal (Refereed) Published
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-3516 (URN)A1985AVH5700002 ()
Available from: 1985-01-01 Created: 1985-01-01 Last updated: 2014-08-29Bibliographically approved
8. Maternal deaths related to cesarean section in Sweden 1951-1980
Open this publication in new window or tab >>Maternal deaths related to cesarean section in Sweden 1951-1980
In: Obstetrics and gynecologyArticle in journal (Refereed) Accepted
Identifiers
urn:nbn:se:umu:diva-3517 (URN)
Available from: 1985-01-01 Created: 1985-01-01Bibliographically approved
9. Maternal deaths in Sweden 1971-1980
Open this publication in new window or tab >>Maternal deaths in Sweden 1971-1980
1986 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 65, no 2, 161-167 p.Article in journal (Refereed) Published
Abstract [en]

Sixty-eight deaths during pregnancy, parturition and puerperium were recorded in Sweden during the years 1971–80, giving a maternal mortality of 6.6 per 100 000 live births. the figurese for abdominal delivery and vaginal were 45.0 and 2.5 per 100000 live births respectively. Am-niotic fluid embolism, pulmonary embolism and hemorrhage were the main causes of death within 24 hours after delivery, while pre-eclampsia/eclampsia and sepsis were predominant during the rest of the puerperium. Age and parity are highly important risk factors. Presumed avoidable factors were identified in 19% of the cases. 9% of the deaths were related to unwanted pregnancy.

Place, publisher, year, edition, pages
Köpenhamn: Munksgaard Forlag, 1986
Keyword
Maternal mortality, pregnancy complications, embolus, cesarean section, puerperal infection
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:umu:diva-3518 (URN)10.3109/00016348609158373 (DOI)A1986C333800013 ()
Available from: 1985-01-01 Created: 1985-01-01 Last updated: 2017-01-10Bibliographically approved

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