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British Medical Bulletin 67:27-37 (2003)
© 2003 Oxford University Press
Beyond the Numbers: reviewing maternal deaths and complications to make pregnancy safer
Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
Correspondence to: Gwyneth Lewis, Director and editor of the United Kingdom Confidential Enquiries into Maternal Deaths and member of the Making Pregnancy Safer Team, Department of Reproductive Health and Research, World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland. E-mail: Gwyneth.Lewis{at}doh.gsi.gov.uk
‘Whose faces are behind the numbers? What were their stories? What were their dreams? They left behind children and families. They also left behind clues as to why their lives end so early1’
Avoiding maternal deaths is possible, even in resource-poor countries, but requires the right kind of information on which to base programmes. Knowing the level of maternal mortality is not enough; we need to understand the underlying factors that led to the deaths. Each maternal death or case of life-threatening complication has a story to tell and can provide indications on practical ways of addressing its causes and determinants. Maternal death or morbidity reviews provide evidence of where the main problems in overcoming maternal mortality and morbidity may lie, produce an analysis of what can be done in practical terms and highlight the key areas requiring recommendations for health sector and community action as well as guidelines for improving clinical outcomes. The information gained from such enquiries must be used as a prerequisite for action.