Trends in maternal mortality due to obstetric hemorrhage in urban and rural China, 1996–2005

Abstract

To analyze the characteristics and trends of maternal deaths due to obstetric hemorrhage in urban and rural areas during the period of 1996-2005 in China, and to provide evidence for decision-making for further reducing the national maternal mortality ratio (MMR). We analyzed national maternal mortality data collected from the Maternal and Child Health Surveillance System of China. The decline of MMR due to obstetric hemorrhage contributed to 91.98% of the overall MMR decline. The adjusted average annual decline rate (AADR) of MMR due to obstetric hemorrhage was 7.30% in rural areas and 2.07% in urban areas. The maternal deaths due to postpartum hemorrhage accounted for the vast majority of maternal deaths due to hemorrhage, and the adjusted AADR was higher in rural areas (7.45%) than in urban areas (1.56%). Although the risk of maternal deaths from hemorrhage decreased substantially, the gap between urban and rural areas is obvious. Efforts to lower MMR should focus on obstetric hemorrhage, especially postpartum hemorrhage, in rural areas. It is recommended that policy-makers should focus on improving the accessibility to and quality of obstetric service in rural areas.