Maternal deaths from suicide in Singapore

INTRODUCTION: Maternal mortality in Singapore, as in other developed countries, has remained low in the past decade. In the United Kingdom and Australia, maternal deaths from suicide and psychiatric causes have been the leading cause of maternal mortality, and there have therefore been comprehensive healthcare programmes to address the mental health needs of mothers. METHODS: In this study, we looked at maternal deaths from 2000 to 2004, by linking coronial cases of female suicide in the reproductive age group 15-45 years, with the birth registration database, to identify both early and late maternal deaths. RESULTS: There was only one identified maternal death among 589 female suicides aged 15-45 years, occurring in a teenager within the first month postpartum. There was likely also another case that was unconfirmed and unreported. CONCLUSION: From this preliminary study, suicide and psychiatric causes are not significant causes of maternal mortality in Singapore. However, given that the epidemiology of postnatal depression statistics mirror that of the other countries, it is possible that maternal suicides have been underreported, and the load may well be higher. There is a need for a similar confidential enquiry into maternal deaths to be set up here, as is already in place in various countries, notably the United Kingdom and Australia, for the past decade.     

Maternal deaths in Australia, 1997-1999

Many maternal deaths in Australia are still preventable.     

Maternal deaths at Songea Regional Hospital, southern Tanzania

During the years 1986 and 1987 there were a total of 7523 deliveries at the Songea Regional Hospital, Southern Tanzania. There were 39 maternal deaths giving a Maternal Mortality Rate of 5.2/1000 deliveries. The major causes of deaths were sepsis following Caesarean section for obstructed labour, ruptured uterus and haemorrhage. 43.6% of the deaths were of women referred from long distances with a diagnosis of prolonged labour. It is stressed that early and facilitated referral, together with the use of the partogram in labour and use of family planning services will reduce the high maternal mortality rate in this region.     

Maternal deaths in South Australia 1970 to 1975.

During the period from 1970 to 1975 there were 128 087 confinements in South Australia and 30 maternal deaths were reported, representing a maternal mortality rate of 23 per 100 000 confinements which is lower than in previous reports. Twenty-one deaths were directly due to complications of pregnancy and childbirth, and nine were due to associated conditions. The fall in the maternal mortality rate was largely due to a reduction in the number of deaths from abortion and in the number of confinements to women in the higher-risk older age groups. Infection appeared for the first time as a major cause of maternal death. Avoidable factors may have contributed to 47% of the deaths.