Women Are Still Dying From Childbirth
WebMD News Archive
May 25, 2000 (San Francisco) -- In Los Angeles County, where inlaid stars
give testament to celebrity on Hollywood Boulevard, women are still dying
giving birth to children, says a doctor who studied 17 years of birth records
at a Los Angeles hospital.
Robert B. Gherman, MD, says the death rate for women in labor during the
years 1982 to 1998 was about 24 per 100,000 live births, a rate that is three
times the CDC-reported national average. Gherman says the leading cause of
maternal death was a condition called preeclampsia/eclampsia, also known as
A very common complication of pregnancy, preeclampsia is characterized by
high blood pressure accompanied by painful swelling of feet, legs, and hands.
Left untreated, the condition can damage the kidneys and cause seizures. During
the 1980s, almost 30% of the maternal deaths at L.A. County Hospital were
caused by preeclampsia, says Gherman. The percentage dropped slightly, to about
26%, from 1990 through 1998.
Bleeding was another leading cause of maternal death, as was infection and
blood clots, says Gherman. He says the take-home message is that "women
still die in childbirth."
Gherman tells WebMD he collected the data from records of almost 220,000
live births. At the time, Gherman was with the L.A. County/University of
Southern California Women's Hospital. "This is an excellent data source
because the hospital records are [collected] within 42 days of delivery,"
says Gherman. Now director of the division of obstetrics/gynecology at the
Naval Medical Center Portsmouth in Portsmouth, Va., Gherman presented his
research at a meeting of ob/gyns here this week.
Judith Weiss, ScD, director of the Massachusetts Maternal Mortality Study in
Boston, tells WebMD that her group will also report maternal death much higher
than the CDC rates. The Massachusetts study, she says, defines maternal death
as deaths occurring up to a year after delivery. Both the CDC and Gherman use
the 42-day cutoff. She says "it is more accurate to extend to a year
because many of these delivery-related deaths ... are likely to occur beyond 42
days." She says, however, that "most deaths do occur within the 42
Weiss says her group will be reporting data from 1995 to 1998 "and the
rate will be about 25%."
Gherman says the best way to approach the problem of women dying during
childbirth is to get high-risk women "out of community hospitals and into
large referral centers, where they can be offered state-of-the-art
Weiss agrees and says that "there continues to be a need for regional
centers that are equipped to handle high-risk cases." She adds that in some
cases, such as HIV-infected women, "ob/gyns have to be willing to
collaborate with other specialists to deliver care."
The goal of the CDC's Healthy Women 2000 campaign is 3.3 maternal deaths per
100,000 live births, says Gherman. He says, however, "The data from L.A.
County suggest that the goal is nowhere in sight."
- A researcher reports that between 1982 and 1998, three times more mothers
died in childbirth in a Los Angeles County hospital than the national average
reported by the CDC.
- The leading killers were bleeding and preeclampsia (which, in the mother,
causes high blood pressure, swelling, and the possibility of kidney damage and
- Other researchers are also finding their maternal death rates are much
higher than the CDC's average. The researchers call for regional centers to be
created in order to give mothers at high risk the most advanced care