A twenty-five year review of maternal mortality in Barbados: 1970-1994

ABSTRACT

Maternal mortality is a sensitive indicator of the health status of a country, reflecting not only the quality of obstetric care, but of all services which contribute to the well-being of women of reproductive age. All maternal deaths taking place in Barbados in the twenty-five year period 1970-1994 were ascertained and the causes of death documented. The overall maternal mortality rate was 86 deaths per 100,000 live births, and unexpectedly high level of mortality. The major causes of deaths were sepsis, complications due to ectopic gestation and abortion, haemorrhagic complications and hypertensive disorders of pregnancy. Improvements in the provision of services resulted in no deaths due to sepsis being documented after 1985, nor were there any deaths attributed to complications of abortion or ectopic gestation after 1989. We note a reduction in the annual mortality rate over the last decade of the period reviewed, albeit significantly less than expected given the level of improvement in health care services. In particular, the maternal mortality rate due to hypertensive disease of pregnancy had remained unchanged. Further research is therefore necessary to elucidate factors which affect the access of patients to health care services, as well as their utilisation of such services. Furthermore, research aimed at evaluating the actual services available to pregnant women might also be appropriate, in order to allow the formulation of strategies aimed at reducing the maternal mortality rate further.(AU)