CEMACH

Chapter 14: Coincidental and Late deaths

Gwyneth Lewis

Introduction

This Chapter considers the lessons which can be drawn from the deaths of pregnant or recently delivered mothers which were not related to pregnancy. These are those women’s deaths, apparently unconnected with pregnancy, which occur either in the antenatal period or up to one year after birth, miscarriage, ectopic pregnancy or a termination of pregnancy. Such deaths, which occur before or up to six weeks after delivery are internationally defined as fortuitous, although the authors of this Report prefer to use the term Coincidental. Deaths which occur after this period, but up to and including 365 days after delivery are classified as Late.

Although neither Coincidental or Late deaths, in international terms, are considered to be true maternal deaths and do not contribute to the calculations for any international  maternal mortality rates or ratios, some contain important messages for the providers of maternity care. Clinically the lessons may include basic principles for the management of pregnant or recently delivered women with underlying medical or psychiatric conditions. From a public health perspective, the continuing assessment of such deaths re-enforces the need for information on the correct use of seat belts whilst pregnant, and, perhaps most importantly, the voluntary identification and management of pregnant women who suffer from domestic abuse. This is discussed in Chapter 13.