Abstract
In a 2-year retrospective analysis of 147 maternal deaths in South African urban and rural hospitals, the maternal mortality rate (MMR) was estimated to be 144 per 100 000 live births. MMR was significantly higher (P = 0.025) in urban hospitals (160 per 100 000) and the main causes of death were hypertensive disease in pregnancy (33%), of which eclampsia contributed to 70% of deaths, and haemorrhage (18%). Only 49.7% of women who died, attended an antenatal clinic. The MMR in South Africa is lower than sub-Saharan countries but unacceptably high for a country with a mix of private and public medicine. Disparities have been noted in maternal mortality rates within the country due to different study designs and poor documentation. Structural changes in the health care system would only be possible if a common information database system were established and confidential enquiries held into maternal deaths.
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