The postpartum period: the key to maternal mortality

OBJECTIVES: To assess postpartum care at an international level, we reviewed published literature on postpartum maternal deaths. METHODS: Meta-analysis was used to summarize the literature reviewed. Postpartum deaths in developing countries were compared with those in the United States. RESULTS: In both developing countries and the United States, > 60% of maternal deaths occurred in the postpartum period; 45% of postpartum deaths occurred within 1 day of delivery, > 65% within 1 week, > 80% within 2 weeks. In developing countries, 80% of postpartum deaths caused by obstetric factors occurred within 1 week. CONCLUSIONS: The first 24 h postpartum and the first postpartum week is the high risk of postpartum deaths, and the risk remains significant until the second week after delivery. In developing countries, hemorrhage, pregnancy-induced hypertension complications, and obstetric infection are commonest causes of postpartum deaths. We suggest primary prevention, early detection, and secondary prevention of postpartum deaths.