Trends and risk factors of maternal mortality in late-nineteenth-century Netherlands

markdownabstractUsing family reconstitution data from the Dutch provinces of Groningen, Drenthe, and Zeeland, trends and risk factors of maternal death from 1846 to 1902 are studied. Findings confirm other studies of maternal mortality trends for the Netherlands in the last quarter of the nineteenth century and show that rates were already steadily decreasing in the mid-nineteenth century. The role of biological and social risk factors including age, parity, birth interval, social class, season, and year of giving birth were also explored. Among biological factors we find an increased risk of maternal death for short birth intervals, late maternal age, high and low parity, multiple gestations, and stillbirths. Social factors associated with increased risk are belonging to the skilled working class, being a farmer, giving birth in winter or spring, and giving birth in earlier years. We also explore trends in the data which reveal directions for future research