For women in the Netherlands, the risk of dying during pregnancy or childbirth has decreased more than tenfold since the middle of the twentieth century. The largest decrease was in the period 1950-1970. According to recent figures from Statistics Netherlands, since 2007 fewer than ten women a year have died during pregnancy and childbirth. The risk of dying while pregnant or giving birth is higher for older women.
Sharp fall in pregnancy and childbirth-related mortality of mothers
In 1950, 241 women died during pregnancy or while giving birth, the equivalent of 105 women per 100 thousand live born babies. This number fell substantially up to the early 1970s, among other things as a result of better antenatal, delivery and post-natal care, but also of the introduction of birth control, including the pill. Since the 1970s, fewer than 14 women per year have died per 100 thousand live born children. Since 2007, the figure has even fallen to fewer than five maternal deaths per 100 thousand babies. This is the equivalent of fewer than ten women per year dying from complications during pregnancy and childbirth.
Deaths of women during pregnancy or childbirth
Older women have higher risk of dying during pregnancy or childbirth
To get a more reliable picture of age, ethnic origin and cause of death, a period of 15 years was studied. In the period 1998-2012, 182 women died during pregnancy, labour or their maternity period. They were 31.9 years old on average; the youngest was 18, the oldest 50 years old. From the age of 35 years the risk of dying during pregnancy or childbirth is higher than for younger ages. In the group of women aged 34 years and younger, 5.2 women died per 100 thousand live born children, while in the age group 35-39 years this was 10.7 per 100 thousand liver births. In terms of absolute numbers, the study covered 53 women aged 35 to 39 years.
Mortality of women during pregnancy and childbirth
Higher risk for women with a non-western foreign background
Two-thirds of the 182 women who died had a native Dutch background. The mortality rate for this group was 5.4 per 100 thousand live born children. The rate was considerably higher for women with a non-western foreign background: 11.5 deaths per 100 thousand live births. A number of factors may be relevant in this respect, such as language problems affecting use of care during pregnancy and childbirth. Mothers with a non-western background may also have a higher prevalence of health problems such as hereditary anaemia, diabetes and high blood pressure.
High blood pressure important cause, but declining
For the entire period 1998-2012, the main causes of death for women during pregnancy or childbirth were high blood pressure (59 deaths), postnatal complications (32) and pre-existing diseases which complicated pregnancy and childbirth (29). The number of deaths caused by high blood pressure fell strongly between 1998 and 2012. In the last five years of this period, delivery and postnatal complications were the most common causes of death.
Causes of death during pregnancy and childbirth