THE number of women who die as a consequence of pregnancy or childbirth may be nearly twice as high as shown in official figures, which capture only one-third of suicides in the year after giving birth, according to NSW analysis that reveals the true toll of post-natal depression. Suicide was the leading cause of death between six weeks and a year after giving birth or having a termination, followed by violence and heart attacks, according to an examination by researchers from the University of NSW of a seven-year period ending in 2001. Each of the 76 deaths during the period was classified as being probably linked - either directly or indirectly - to the recent pregnancy."Many of these deaths were among vulnerable women post-pregnancy and are an important group of often preventable deaths," said the leader of the study, Elizabeth Sullivan, from the University's National Perinatal Statistics Unit. Official statistics only link death with recent pregnancy if it occurs within six weeks of the pregnancy ending - the point at which women are usually discharged from formal maternity services, Associate Professor Sullivan wrote in the Australian And New Zealand Journal Of Obstetrics and Gynaecology. Her findings showed monitoring should continue beyond the six-week period, "in recognition of the ability of modern medical care to delay death following severe complications and of the importance of deaths from mental illness in the year following pregnancy and childbirth". She matched state death records against records of new mothers and found 23 suicides that occurred after six weeks. In addition to the 76 who died later in the first year, Associate Professor Sullivan found 97 died within six weeks of their pregnancy ending, including 15 who had not been previously recorded in the state's maternal death statistics - probably because doctors did not mention the recent pregnancy on death certificates. James King, an obstetrician and a past chairman of the National Advisory Committee on Maternal Mortality, said the NSW analysis highlighted inadequacies in Australia's system for recording pregnancy-related deaths. Professor King said the change in the demographic profile of mothers - who were now more likely to be older, overweight and to have a caesarean section than previous generations - meant accurate surveillance of death and serious ill health was essential. The current system of compiling inconsistent state records into a national report was unreliable. Monitoring of pregnancy-related deaths has been the responsibility of federal health department agencies, and its future funding is uncertain. In a preface to the most recent national report on the issue, the director of the Australian Institute of Health and Welfare, Penny Allbon, wrote that it was "concerning that no resources have been identified to sustain and improve this reporting in the future". A professor of obstetrics and gynaecology at the Australian National University and president of Women's Hospitals Australasia, David Ellwood, said accurate reporting would require statutory powers for investigators to request medical records from state health departments, to independently assess the cause of death.
Monday, September 8, 2008
Figures Mask True Pregnancy Death Rate
From the Sydney Morning Herald