Times of India
15 April 2010
By Denise Grady

A study cited lower pregnancy rates, higher income, more education for women, and the increasing availability of ‘skilled attendants’ as reasons behind the decline in mortality
For the first time in decades, researchers are reporting a significant drop worldwide in the number of women dying each year from pregnancy and childbirth, to about 342,900 in 2008 from 526,300 in 1980. The findings challenge the prevailing view of maternal mortality as an intractable problem that has defied every effort to solve it.

“The overall message, for the first time in a generation, is one of persistent and welcome progress,” the journal’s editor, Dr Richard Horton, said.

The study cited a number of reasons for the improvement: lower pregnancy rates in some countries, higher income, which improves nutrition and access to health care, more education for women, and the increasing availability of “skilled attendants” – people with some medical training – to help women give birth. Improvements in large countries like India and China helped to drive down the overall death rates.

But some advocates for women’s health tried to pressure The Lancet into delaying publication of the new findings, fearing that good news would detract from the urgency of their cause, Dr Horton said.

The researchers analysed maternal mortality in 181 countries from 1980 to 2008, using death records, censuses, surveys and studies.

Among poor countries with longstanding high death rates, progress varied considerably. For instance, from 1990 to 2008, the maternal death rate dropped 8.8% a year in the Maldives, but rose 5.5% in Zimbabwe. Sub-Saharan Africa has the highest maternal death rates. Brazil improved more than Mexico, Egypt more than Turkey. Six countries accounted for more than half of all the maternal deaths in 2008: India, Nigeria, Pakistan, Afghanistan, Ethiopia and the Democratic Republic of Congo.

But India has made steady progress, and because its population is so large, its improvements have helped decrease the worldwide rate of maternal deaths. In India, there were 408 to 1,080 maternal deaths per 1,00,000 live births in 1980, and by 2008, there were 154 to 395, the new study found.