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Indigenous maternal death rate alarming|
May 1, 2008
.Aboriginal and Torres Strait Islander women are almost three times more likely to die while pregnant, during labour or up to six weeks after giving birth than non-indigenous women.
And the system for reporting maternal deaths in Australia needs an overhaul, with inconsistent data collection between the states and territories undermining the Australian Institute of Health and Welfare's (AIHW) efforts to provide accurate and timely statistics.
An AIHW report says 65 maternal deaths occurred in Australia between 2003 and 2005, with one woman dying for every 11,896 births.
Advertisement: Story continues below The deaths happened during pregnancy, labour or up to six weeks after birth and were either directly or indirectly related to the pregnancy or its mismanagement.
Twenty-nine were related solely to pregnancy while the remainder were linked to existing conditions such as depression, cardiac problems or substance abuse.
Alarmingly, there were 7.9 deaths per 100,000 non-indigenous women, compared with 21.5 deaths for Aboriginal and Torres Strait Islander women.
The high rate of maternal mortality among indigenous woman has not abated since first measured in the early 1990s.
National Advisory Committee on Maternal Mortality chairman, Associate Professor James King, said the high rate of maternal indigenous deaths was due to a legacy of disadvantage.
"There is no measure of health where indigenous people are as well off as non-indigenous people," he told AAP.
"So it is not something specific to pregnancy. It is related to deep deprivation, it is related to generations of health issues and it is partly related to access and remote living."
Women younger than 17 were at a higher risk of pregnancy related death and the trend of women to delay childbirth into their 30s was not evident in the indigenous population, Prof King said.
Indigenous women can experience complications during childbirth due to conditions they have had since childhood, such as rheumatic heart disease, he said.
"There are (also) situations in Australia where women are giving birth in communities where you don't have immediate access to evacuation," Prof King said.
Australia fares well compared with other countries in the region.
In 2000, Oceania had 240 deaths per 100,000 live births, compared with 8.4 in Australia.
The leading causes of maternal deaths for all Australian women were amniotic fluid embolism, high blood pressure and blood clotting.
An amniotic fluid embolism is a rare event when toxic fluid inside the amniotic sac escapes into a woman's bloodstream and she experiences circulatory collapse.
Reporting of maternal deaths is not mandatory at a national level and data is collected separately by each state and territory.
Data including indigenous status and caesarean section was not consistently collected across the country.
Prof King said there was no federal funding available for the production of the next maternal deaths report, measuring the 2006-08 period.
"We are concerned federally there doesn't seem to be as much support for measuring maternal mortality as there should be," he said.
"The data is not of sufficient quality to enable us to learn the lessons that we should from these tragic cases."
AIHW director Penny Allbon said she was concerned no resources had been identified to sustain and improve reporting in the future.
"Another key to improving Australia's performance in relation to maternal deaths is the proposed introduction of a national agreed system of review with cross-disciplinary expertise and a standardised audit process."
Health Minister Nicola Roxon said the Australian Health Ministers Advisory Council would consider funding for the report in due course.
"We are determined to turn these figures around," she told AAP.
"We have committed to closing the life expectancy gap within a generation, and that will require determined effort when it comes to maternal health."
Ms Roxon said the government had committed $260 million to a program tackling indigenous maternal and infant health.
"As part of this plan, we will be introducing a new plan for nurse home visits," she said.
"This program will provide structured, sustained home visiting by skilled health professionals, starting during pregnancy."