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'Shocking' figures show women from deprived backgrounds 20 times more likely to die in pregnancy.

THE most disadvantaged women in society are 20 times more likely to die during pregnancy or in the months after giving birth than those from higher social classes, a report found.

The Confidential Enquiries into Maternal Deaths (CEMD) report uncovered a "distressingly" high number of suicides within the first year after childbirth, many of which could have been prevented.

It also confirms that black or Asian women have double the risk of death than white women.

The figures, described as "shocking" by the Royal College of Obstetricians and Gynaecologists, were published in the CEMD's UK-wide report, Why Mothers Die 1997-1999.

They prompted immediate calls for changes in the delivery of maternity care and more midwives.

The report found 60pc of deaths directly related to the pregnancy had suffered some form of substandard care and 50pc had "major" substandard care in which different treatment might have affected the outcome.

The main causes were a lack of communication and team work, a failure to appreciate the severity of the illness, wrong diagnoses and failure of consultants to attend.

Although the report found the number of maternal deaths to be at their lowest yet, it also describes the "unexpected" effect of social deprivation on maternal mortality.

These deaths are blamed on a lack of initial contact with maternity services, irregular clinic attendance, poor general health, co-existing diseases and substance misuse.

A disproportionate number of women from the travelling community were likely to die while 12pc of all the women who deaths were included in the report said they were victims of domestic violence.

Professor James Drife, clinical director of the CEMD, said, "We are pleased that these are our best ever obstetric results but we are very concerned about the effects of social class, ethnic differences, and domestic violence.

"More can and should be done to address these issues. Whilst the number of maternal deaths is small, the findings are socially significant.

"Each case in this report represents an individual tragedy. In some, a woman died despite exemplary care but in others a fatal outcome might have been avoided.

"Today, the authors of this report can still feel anger at the way the system continues to fail some vulnerable young women.

"Maternal mortality rates are higher among the most disadvantaged groups of our society. What we did not expect was to find a twenty-fold difference in the risk of death."

The CEMD report said that between 1997 and 1999 there were 378 maternal deaths identified.
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Publication:Western Mail (Cardiff, Wales)
Date:Dec 7, 2001
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