I was in fact reading the Maternal Deaths report at work today, the most recent complete one (94-96); over the past 30 years maternal deaths have decreased but hit a steady patch over the last few triennial periods. As Marilyn says, many were extremely ill, to the point where one must wonder at their choosing to embark on or maintain a pregnancy; some had reappearance of malignancy (particularly Ca Breast and Malignant Melanoma); some refused treatment early in the disease process (PIH, other hypertensive states); some had catastrophic haemorrhages and infections particularlu Gp A Streptococcus Pyogenes (what's that? never heard of it). There were a surprising number of amniotic fluid embolism, occurring in women not necessarily given induction agents which surprised the examining panel also. Many had LSCS and subsequently died but it would be hard to attribute death solely or even largely because of that. It's very interesting reading. For that triennium, maternal death Australia wide was 13/100,000; in 1964-66 it was about 40/100,000 and even in 1970 it was 30/100,000.
Monica
----- Original Message -----
Sent: Tuesday, June 01, 2004 1:37 AM
Subject: Re: [ozmidwifery] caesarean section

MIchelle:
 
I would urge you to go actually read the case studies around these maternal mortality stats. The studies are also on the web site, at least they were because I downloaded them a couple of years ago. What I found/interpreted were many very ill women with various cardiovascular disorders plus women with rapidly escalating pre-eclampsi/eclampsia and one immediate postpartum eclamptic seizure (after an NVB and early d/c). For most of the women who died it would seem to me that caesarean birth was their only option for surviving childbirth, in another time they would probably not attempted to conceive.
 
In thinking about this I have wondered for a while how this increasing maternal mortality is related to the increasing c/s rate, simply because these women were true cases of needing c/s in other words they were definetly not elective c/s nor did any of the cases represent unnecessary c/s, at least not to my mind. I now think there is an indirect link. Perhaps,  in the ether of the promotion of the choice and safety of caesarean birth women who otherwise would have considered themselves too ill to undergo pregnancy and childbirth consider childbearing a possibility and then it becomes a probability.
 
 
I am sure there are other possibilities.
 
marilyn
 
 
 
 
 
 
 
 
----- Original Message -----
Sent: Sunday, May 30, 2004 6:52 AM
Subject: [ozmidwifery] caesarean section

Hi,
I'm new to the list but had to add a bit to the caesarean section issue.  Doing an assignment last year we had to analyse some perinatal statistics (Qld).  In the last 30 years the maternal mortality rate has slowly and steadily increased (figures up to 1996)  and while they didn't give a breakdown on the maternal deaths, surely this has to be due to the slow but steady increase in caesarean section?  It is unbelievable that in 30 years of medical advances that more women are dying - and no one is looking for the cause.  I didn't see the 60 minutes program, but was there any mention of the increased maternal mortality with caesareans?
 
Michelle



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