Maternal deaths in Australia 2008–2012

This is the 16th report on women in Australia who die in association with pregnancy and childbirth. Authored by AIHW, Humphrey MD, Bonello MR, Chughtai A, Macaldowie A, Harris K and Chambers GM. Summary Maternal deaths in Australia 2008-2012 provides a summary of statistics on maternal mortality in Australia to inform safety and quality of maternity care in Australia, and provides good practice guidance from members of the National Maternal Mortality Advisory Committee (NMMAC). In 2008-2012, there were 105 maternal deaths in Australia that occurred within 42 days of the end of pregnancy, representing a maternal mortality ratio (MMR) of 7.1 deaths per 100,000 women who gave birth in Australia. The number of maternal deaths increased each year from 2008 to 2012. It is uncertain whether this is an actual increase or reflects improvements in case ascertainment. There were 49 maternal deaths directly related to the pregnancy in 2008-2012. Fifty-three deaths were indirect maternal deaths, due to non-pregnancy related conditions aggravated by the pregnancy or its management. Three maternal deaths could not be classified as direct or indirect deaths. The women who died were aged between 17 and 50. Women aged 40 and over, women who are obese with a body mass index (BMI) of 30 or more, and women of Aboriginal and Torres Strait Islander origin, were among those at increased risk of maternal death. Maternal mortality in Australia has been reported since the 1964-1966 triennium. The direct MMR in the 1964-1966 triennium (30.3 deaths per 100,000 women who gave birth) was 10.4 times higher than the direct MMR in the 2009-2011 triennium (2.9 deaths per 100,000 women who gave birth). The total MMR has fallen from 12.7 deaths per 100,000 women who gave birth in 1973-1975 to 7.2 deaths per 100,000 women who gave birth in 2009-2011. Key causes of maternal death in Australia in 2008-2012 The leading causes of direct maternal death were obstetric haemorrhage (11), thromboembolism (10) and hypertensive disorders (9) and, when combined, these accounted for more than 61% of all direct maternal deaths. The leading cause of indirect maternal death was cardiovascular disease (15). There were 16 deaths due to psychosocial causes, including 12 due to suicide. Five of the direct deaths due to obstetric haemorrhage were related to the presence of pathological placentation (placenta accreta and/or percreta), and 5 were due to postpartum haemorrhage. Five non-obstetric haemorrhage deaths resulted from rupture of a splenic artery aneurysm and 5 were due to intracranial haemorrhage. Aboriginal and Torres Strait Islander maternal mortality Maternal mortality for Aboriginal and Torres Strait Islander women is double that of other Australian women, with an Aboriginal and Torres Strait Islander MMR of 13.8 deaths per 100,000 women who gave birth compared with 6.6 deaths per 100,000 for other Australian women who gave birth. Although the differential between the MMRs is decreasing, caution should be exercised in drawing conclusions due to the small numbers being analysed. Cardiovascular conditions, sepsis and psychosocial conditions were the leading causes of maternal deaths among Aboriginal and Torres Strait Islander women