The birth rate this year is extraordinarily high, and mother-infant safety has therefore become the focus of public attention.

Mortality of pregnant women and puerperae is an important indicator of the health status of the people in a region. With the development of the country’s social economics as well as the improvement of health care conditions, the mortality of pregnant women and puerperae is decreasing year by year.

Take Beijing for example. Mortality of pregnant women and puerperae last year was 7.9 per 10 thousand, which is the lowest in the history and has reached the developed countries’ level. However, the mortality of pregnant women and puerperae among floating population was discouraging, which was still remarkably higher than Beijing residents despite the overall declining trend. The mortality of pregnant women and puerperae among floating population is generally 3 to 5 times higher than the residents in Beijing, while the mortality of latter is not stable, either. Hence, efforts are still to be lower pregnant woman mortality which is the focus of our long-term work in the future.

What are the main causes of the death of pregnant women and puerperae?

The causes for maternal death can be put into 2 categories, which are direct and indirect obstetric causes. Direct obstetric cause includes postpartum hemorrhage, amniotic fluid embolism, pregnancy induced hypertension syndrome and ectopic pregnancy; indirect obstetric cause mainly consists of internal complications. In recent years, indirect obstetric factors have become the major cause for death of pregnant women and puerperae in the city, accounting for 53% of the total. However, the major causes for the death pregnant women and puerperae among floating population are direct obstetric factors, accounting for 69.8%, of which postpartum takes the biggest part, accounting for 30.2%. In terms of the cause of death, the situation of Beijing residents is in agreement with developed countries; while the floating population is consistent with developing countries.

For a mother-to-be, gestation of a new life is a beatific process, where also exist certain risks. Then, how can we mitigate such risks?

  The renowned late obstetric specialist, Doctor Lin Qiaozhi once remarked:“ Pregnancy is no disease, when warded in advance.” The first disease-prevention measure should be preferably taken before pregnancy. In other words, the couple should go to hospitals to take a pre-pregnancy physical examination. Particularly in China nowadays where compulsory pre-marriage physical examination has been cancelled, pre-pregnancy examination becomes increasingly important.

If a woman is found to suffer from some disease, like serious heart disease, renal disease, liver disease and communicable disease, which make pregnancy become inappropriate or temporarily inappropriate, contraception measures should be adopted in compliance with the doctor’s instruction to avoid indirect obstetric death caused by internal complications. The second disease-prevention measure should be implemented during the period of pregnancy. Pregnant women should regularly take prenatal examination, so that treatments can be timely conducted once any abnormal situation is detected. By doing so, mortality caused by direct obstetric factors such as pregnancy-induced hypertension syndrome and ectopic pregnancy can be avoided.

The third disease-prevention measure should be adopted during the stage of labour. According to the statistics, the proportion of the pregnant women dying at home or on the road to hospitals among floating population is higher than that among Beijing residents. Such deaths were mainly caused by postpartum hemorrhage after labour at home or at private clinics. Thus, we appeal to the pregnant women among floating population to undertake prenatal examination and to give birth in standard hospitals rather than at private clinics, in order to ensure the safety of the mother and the enfant. 

In addition, frequent medical or induced abortions may have a strong impact on women’s reproductive health, and lead to ectopic pregnancy, which has, in recent years, effectuated  several cases of death of puerperae in our city. Therefore, women are suggested to keep vigilance against such occasions.