Pregnancy Complications and Death

What's the Problem?

When a woman dies during pregnancy or within a year of pregnancy and the problem can be traced to the pregnancy, the death is said to be pregnancy-related. The problem may be a direct result of the pregnancy complications or an unrelated condition that was made worse by the pregnancy.

The woman may hemorrhage, have seizures or have a pulmonary embolism, which may lead to hospitalization or death. The baby may or may not live.

The major causes of pregnancy-related deaths are excessive bleeding, pre-eclampsia and eclampsia (high blood pressure unique to pregnancy), and clots to the lungs. For every woman who dies from pregnancy, several thousand more experience complications. About one-fifth of the four million women who deliver in the U.S. each year have a serious problem before they start labor and one-quarter will have a serious complication during labor or delivery.

Who's at Risk?

Women at greatest risk of dying from pregnancy are those who do not receive medical care during their pregnancy. Some women do not have access to medical care due to lack of insurance or transportation.

At-risk women can be of any socioeconomic background or race; however, African American women are four times more likely to die from pregnancy-related causes than white women, and the disparity in risk between black women and white women has increased from 3.4 times greater in 1987 to 4.1 in 1990.

Also at greater risk are women 35 years of age and older, women who have had three or more children, and women who may lack resources, support, or prenatal care.

In the U.S., 49% of all pregnancies are unintended. Half of unintended pregnancies are among women not using any birth control. The other half is among women using birth control but whose method failed due to inappropriate use or failure of the method itself.

Can It Be Prevented?

Pregnancy-related deaths are not always preventable. However, it is estimated that up to half of all pregnancy-related deaths could be prevented through regular check-ups during pregnancy and appropriate management of health problems.

Tips for Scripts

• REMIND viewers to seek medical care during pregnancy.
• ENCOURAGE viewers not to smoke or drink alcohol during pregnancy.
• ENCOURAGE viewers to plan their families and see a doctor before getting pregnant.
• INFORM viewers to never take medications unless prescribed by a physician familiar with their case.
• REMIND women to follow their doctor's advice for vitamins and care during pregnancy and to take folic acid before conception to prevent birth defects.

Case Example

A 36-year-old woman has three children and doesn't want to get pregnant. But her partner doesn't want her to use contraception. She becomes pregnant and because the pregnancy is not wanted, she does not seek prenatal care or take good care of herself. She develops swelling in her feet and hands, gains weight rapidly, and experiences headaches and blurred vision. At delivery, her blood pressure increases dramatically, and she develops convulsions and dies. The baby also dies.

Note: The high blood pressure during pregnancy could have been detected, monitored, and controlled before delivery had she received prenatal care.