The nation’s maternal mortality rate is much higher than the official estimate, Chang Gung Memorial Hospital director of obstetrics Cheng Po-jen (鄭博仁) said yesterday at a celebration for the establishment of the Taiwan Maternal Fetal Medicine Society.
One of the UN’s 8 Millennium Development Goals set in 2000 was to reduce the maternal morality ratio (MMR) by 75 percent by 2015, Cheng said, adding that as the deadline approaches the world is nowhere near achieving that goal.
Despite announcing its MMR to be at five to six per 100,000 live births, Taiwan actually has an MMR that is likely to be seven to eight times higher than the official number, Cheng said.
“Taiwan has an unclear definition for maternal death, and the statistics are hazy. In Taiwan, the cause of maternal death is limited to two conditions, amniotic fluid embolism and postpartum hemorrhage [PPH],” without counting in the deaths caused by complications in high-risk pregnancies, Cheng said.
Cheng added that other reasons for to the underestimation include a lack of an effective informing system and a maternal mortality review system, which together would allow “each case of maternal death to be identified, reviewed and reported.”
Speaking on his presentation topic, “Toward Reducing Maternal Mortality and Morbidity: the Role of Maternal Fetal Medicine Sub-specialists,” Cheng said that maternal fetal medicine needs to carry out three steps to achieve a reduction in MMR, namely: establishing a training system for maternal fetal specialists; improving existing maternal care and management; and building a credible analytical statistics system for the reporting of maternal deaths.
Cheng suggested standardizing reporting criterion for maternal death, to clearly define maternal morbidity and “near misses;” to have a stratified maternal and neonatal care system and a clear classification standard for the necessary referral of patients, and to conduct research on how suboptimal pregnancy outcomes affect women’s health.