In Australia, where childbirth is safe for most women, maternal death is rare. All maternal deaths are reviewed by health professionals to determine the likely cause and whether the pregnancy contributed to the death.

Maternal death is the death of a woman while pregnant or within 42 days of the end of pregnancy, regardless of the duration or outcome of the pregnancy. Maternal deaths are divided into two categories, direct and indirect. Direct deaths are those resulting from obstetric complications of pregnancy or its management. Indirect maternal deaths are those resulting from diseases or conditions that were not due to a direct obstetric cause, but were aggravated by the physiologic effects of pregnancy. Deaths considered to be causally unrelated to pregnancy are classified as coincidental (see below for more information on these deaths).

Download Maternal deaths in Australia 2016

Infographic showing that in 2016 there were: 19 maternal deaths, 7 per 100,000 women giving birth; 11 direct, 8 indirect and 1 not classified types of maternal deaths; the highest causes of death were suicide 4 and thromboembolism 3.

Maternal mortality over time

The incidence of maternal death is expressed as the maternal mortality ratio (MMR). The MMR is calculated using direct and indirect deaths (excluding coincidental deaths) and expressed as per 100,000 women giving birth. The MMR in Australia was relatively stable between 2006 and 2016. Fluctuations appear to reflect the normal variability that might be expected with rare events such as maternal deaths.

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Causes of maternal deaths

The most frequent causes of maternal death reported in Australia between 2006 and 2016 were non-obstetric haemorrhage (mostly haemorrhage within the brain and haemorrhage from a ruptured aneurysm of the splenic artery) and complications of pre-existing cardiovascular disease.

The most frequent causes of direct maternal death between 2006 and 2016 were thromboembolism, amniotic fluid embolism and obstetric haemorrhage.

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Coincidental deaths are defined as those that are reported to have occurred during pregnancy or within 42 days of the end of pregnancy, but are considered to be causally unrelated to pregnancy. Unlike direct and indirect maternal deaths, coincidental deaths are excluded from analysis and MMR calculations.

There were 55 coincidental deaths in Australia from 2006–2016. The most common causes of these deaths were motor vehicle trauma and cancer. For more information visit data tables 1 & 2.

Timing of maternal deaths

Understanding the timing of maternal deaths is important for identifying periods of critical risk. Between 2006 and 2016, of the women who were reported to be pregnant at the time of their death, two in five (22, 38.6%) died during the first trimester (less than 14 weeks of pregnancy). One in five (38, 21.1%) maternal deaths were reported to have occurred during the birth process or within 24 hours of giving birth. These proportions do not include maternal deaths following or due to miscarriage or termination of pregnancy as the timing of death was not adequately reported for these cases.

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Characteristics of women who died

This section presents some demographic characteristics of the women who died from 2012–2016. It should be noted that not all demographic information was available for all women who died.

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Maternal age

Between 2012 and 2016, the incidence of maternal death was higher for younger and older women, with the lowest incidence of maternal death occurring between the ages of 20 and 34 (MMR 5.1 per 100,000 women who gave birth). This pattern was consistent for both indirect and direct maternal deaths.

Maternal Indigenous status

Between 2012 and 2016, the age-standardised MMR for Aboriginal and Torres Strait Islander women was 31.6 per 100,000 women who gave birth. Due to differences in the age structure between the Australian Indigenous population and the non-Indigenous population, the MMR has been directly age-standardised to the Australian female population aged 15–44 at 30 June 2001.

Parity

Parity refers to a woman’s number of previous pregnancies, excluding the current pregnancy, carried to a viable gestational age (usually 20 weeks). Women with a parity of 3 or higher were 2.6 times more likely to die as women with a parity 0 to 2 (MMR 15.2 per 100,000 women who gave birth and 5.7 per 100,000 women who gave birth, respectively).

Smoking status

Maternal death was more common in those who reported smoking during the first 20 weeks of pregnancy than in those who reported that they did not smoke during the first 20 weeks of pregnancy (20.2 per 100,000 women who gave birth and 3.7 per 100,000 women who gave birth, respectively). As the number of maternal deaths with an unknown smoking status is relatively high (34.2% of data from included jurisdictions), caution should be taken when interpreting these data.

Remoteness

The Australian Standard Geographical Classification (ASGC) for Remoteness areas defines each category based on the physical distance of a location from the nearest urban centre and population size. Women who lived in Major cities and Inner regional Australia had an MMR of 6.8 and those who lived in Outer regional, Remote or Very remote locations had a combined MMR of 9.6 per 100,000 women giving birth. The incidence of maternal death in areas other than major cities of Australia should be treated with caution due to the small numbers.