Maternal Mortality
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ested Reading Carnes, P. J. (1991). Don’t call it love: Recovery from sexual addiction. New York: Bantam Books. Levine, S. B. (1992). Sexual life: A clinician’s guide. New York: Plenum Press.
Suggested Resources Betty Dodson Online: http://www.bettydodson.com (1998–2002). Betty Dodson, Ph.D., New York.
GARY MARTZ
Maternal Mortality Deaths to women that are associated with pregnancy and childbirth fall under the category of maternal mortality. There are more than 500,000 maternal deaths each year in the world, of
which almost all (98%) occur in developing nations, but even in the United States two or three women die each day of pregnancy-related causes. Regionally, the lifetime risk of maternal death is highest in Africa, where 1 in every 16 women is likely to be a victim. The risk of maternal death is 1 in 65 in Asia, 1 in 130 in Latin America, but is dramatically lower—1 in 1,800 women— in high-income nations. It is also estimated that for each woman who dies of complications of labor and delivery, at least 30 and possibly as many as 100 women survive childbirth but suffer from disease, disability, or other physical damage as a result of the complications of pregnancy. An accurate assessment of maternal mortality rates is difficult to obtain, since the areas with the highest rates are often the same places that have the least accurate recordkeeping systems. In developing nations, people often die outside the health care system, and the cause of death is often not recorded even if a death occurs in a hospital. Furthermore, the number of deaths from unsafe (typically illegal) abortion is often underestimated, because the procedure may have been performed in secrecy. In both developing and developed countries, the recorded cause of death may be misclassified if the link to a pregnancy is not recognized. There are numerous causes of maternal mortality, but 80% of deaths in the world are due to five primary complications. These include hemorrhage (25% of maternal deaths), sepsis (15%), toxemia (12%), unsafe abortion (13%), and obstructed labor (8%). The remaining 20% are often due to associated conditions, such as malaria, anemia, and HIV/AIDS. One in four maternal deaths occurs during childbirth, half occur within the first 24 hours after birth, and the remaining 25% occur in the days and weeks immediately following delivery. Complications that do not result in death can create lifelong conditions such as infertility, impaired mobility, severe anemia, chronic weakness, pelvic pain, uterine rupture, and fistula. Worldwide, the availability of women’s health services makes a significant impact on levels of maternal mortality and morbidity. According to data from the United Nations Population Fund (UNFPA), approximately 15% of pregnant women experience some kind of complication, and about 5% of pregnant women require surgery, usually a cesarean section. Note that in the United States nearly one in four deliveries is by cesarean section, but that is a far higher percentage than would be required if it were used solely t
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