Maternal death

Most women have healthy pregnancies and healthy babies. But sometimes things can go wrong. A woman can have complications that can cause problems for her and her baby. Rarely, these complications are so severe that they cause a woman’s death.

Maternal death (also called pregnancy-related death) is when a woman dies during pregnancy or within a year after pregnancy from health problems related to pregnancy or childbirth. Maternal death is rare in the United States. In this country, there are about 4 million births and about 650 maternal deaths each year.

Getting regular health care before, during and after pregnancy can help you stay healthy and help prevent maternal death. If you’re planning pregnancy, get a preconception checkup to take care of any health problems you may have before you get pregnant. During pregnancy, get early and regular prenatal care. Getting regular prenatal care lets your health care provider spot and treat health problems that may affect your pregnancy. After you give birth, keep an eye out for warning signs of health problems, including infections and bleeding, that could become dangerous.

What kinds of health problems can cause maternal death?

In the United States, these health problems are common causes of maternal death:

  • Cardiovascular diseases, like stroke and high blood pressure. These diseases affect your heart and blood vessels. During pregnancy, you have nearly twice as much blood moving through your body than you did before pregnancy. This means your heart has to work harder to pump blood to the rest of your body.

    Stroke happens when a blood clot (a mass or clump of blood) blocks a blood vessel that brings blood to the brain, or when a blood vessel in the brain bursts open. Changes in hormones (chemicals made by the body) during pregnancy and childbirth may increase your chances of having a stroke. Pregnancy and childbirth cause strokes in about 8 in 100,000 women. Stroke can cause lasting damage to the body or death.

    High blood pressure
    (also called hypertension) is when the force of blood that pushes against the walls of your arteries is too high. Arteries are blood vessels that carry blood away from the heart to the body. Without treatment, high blood pressure can lead to stroke or heart failure. Heart failure is when the heart can’t pump enough blood. Your health care provider takes your blood pressure at each prenatal care checkup to make sure your blood pressure is healthy.

    If you have both high blood pressure and protein in your urine during pregnancy, you have a condition called preeclampsia. Without treatment, preeclampsia can cause serious health problems. Sometimes it becomes a life-threatening condition called eclampsia. Eclampsia is when a pregnant woman has seizures following preeclampsia.
  • Amniotic fluid embolism. This is a very rare condition that usually happens during or right after a tough labor and birth. It happens when some of your baby’s cells, hair or amniotic fluid (fluid that surrounds your baby in the uterus) get into your bloodstream and move to your lungs. This can cause the arteries in your lungs to become narrow. This can cause problems, including a fast heart rate, irregular heartbeat, heart attack or death.
  • Anesthesia problems. Anesthesia is medicine that lessens or prevents pain. Your provider may give you anesthesia during labor and birth. Most women don’t have problems from anesthesia, but some react differently to it. If you’re given too much anesthesia, it may affect your breathing, heartbeat or blood pressure. Tell your provider before you go into labor if you’ve had problems with anesthesia in the past.
  • Heart muscle diseases (also called cardiomyopathy). These diseases make your heart larger, thicker or more rigid (stiff) than normal. Sometimes these diseases make the heart weaker, so that it can’t pump blood well. They can lead to problems, like heart failure, irregular heartbeat or fluid buildup in your lungs or legs.
  • Hemorrhage (also called heavy bleeding). Hemorrhage can be deadly if your provider can’t stop it. Preterm labor and placental problems (like placental abruption) can cause heavy bleeding during pregnancy. Preterm labor is labor that happens too early, before 37 completed weeks of pregnancy. Placental abruption is when the placenta separates from the uterus (womb) before birth. The placenta grows in your uterus and supplies the baby with food and oxygen through the umbilical cord. Heavy bleeding after birth can happen if your vagina or cervix (opening to the uterus) is cut or torn during birth, or if your uterus doesn’t contract (tighten) after birth.
  • Infection. An infection is a sickness you get from bad germs. Some infections can lead to deadly illness. In rare cases, pregnant women who have group B strep (an infection from bacteria) may develop sepsis (blood infection). Sepsis can overwhelm the body’s immune system and may lead to severe problems and even death. For example, sepsis sometimes leads to small blood clots that block blood flow to your vital organs, like your brain, heart and kidneys. This can cause organ failure and death.
  • Pulmonary embolism (also called PE). This is a blood clot that blocks an artery in the lung. It usually happens when a blood clot in the leg called deep vein thrombosis (also called DVT) breaks loose and travels to the lung. PE can cause low oxygen levels in your blood. If your organs don’t get enough oxygen, they may become damaged. PE is an emergency and can be deadly. After giving birth, your provider may want you to get up and walk around as soon as you can. This can help prevent DVT and PE.

Last reviewed July 2013

See also: Your checkup before pregnancy, Your first prenatal care checkup, Warning signs after birth

Most common questions

What is mononucleosis?

Mononucleosis (also called mono) is an infection usually caused by the Epstein-Barr virus (EBV). It’s sometimes caused by another virus called cytomegalovirus (CMV). EBV and CMV are part of the herpes virus family. Mono is most common in teenagers and young adults, but anyone can get it. Mono is called the “kissing disease” because it’s usually passed from one person to another through saliva. In addition to kissing, it can also be passed through sneezing, coughing or sharing pillows, drinks, straws, and toothbrushes.

You can have mono without having any symptoms. But even if you don’t get sick, you can still pass it to others. Symptoms can include:

  • Achy muscles
  • Belly pain
  • Fatigue (feeling tired all the time)
  • Fever
  • Sore throat
  • Swollen glands in your neck

If your symptoms don’t go away or get worse, tell your health care provider. He’ll most likely do a physical exam and test your blood to find out for sure if you have mono.

There’s no vaccine to prevent mono. There’s also no specific treatment. The best care is to take it easy and get as much rest as you can. It may take a few weeks before you fully recover.

Can Rh factor affect my baby?

The Rh factor may be a problem if mom is Rh-negative but dad is Rh-positive. If dad is Rh-negative, there is no risk.

If your baby gets her Rh-positive factor from dad, your body may believe that your baby's red blood cells are foreign elements attacking you. Your body may make antibodies to fight them. This is called sensitization.

If you're Rh-negative, you can get shots of Rh immune globulin (RhIg) to stop your body from attacking your baby. It's best to get these shots at 28 weeks of pregnancy and again within 72 hours of giving birth if a blood test shows that your baby is Rh-positive. You won't need anymore shots after giving birth if your baby is Rh-negative. You should also get a shot after certain pregnancy exams like an amniocentesis, a chorionic villus sampling or an external cephalic version (when your provider tries to turn a breech-position baby head down before labor). You'll also want to get the shot if you have a miscarriage, an ectopic pregnancy or suffer abdominal trauma.

I had a miscarriage. How long should I wait to try again?

Before getting pregnant again, it's important that you are ready both physically and emotionally. If you don't need tests or treatments to discover the cause of the miscarriage, it's usually OK for you to become pregnant after one normal menstrual cycle. However, it may take longer for you to feel emotionally ready to be pregnant again. Everyone responds differently to a miscarriage. Only you will know when you are ready to try to get pregnant again.

Are gallstones common during pregnancy?

Not common, but they do happen. Elevated hormones during pregnancy can cause the gallbladder to function more slowly, less efficiently. The gallbladder stores and releases bile, a substance produced in the liver. Bile helps digest fat. When bile sits in the gallbladder for too long, hard, solid nuggets called gallstones can form. The stones can block the flow of bile, causing indigestion and sometimes serious pain. Staying at a healthy weight during pregnancy can help lower your risk of gallstones. Exercise and eating foods that are low in fat and high in fiber, like veggies, fruits and whole grains, can help, too. Symptoms of gallstones include nausea, vomiting and intense, continuous abdominal pain. Treatment during pregnancy may include surgery to remove the gallbladder. Gallstones in the third trimester can be managed with a strict meal plan and pain medication, followed by surgery several weeks after delivery.

©2013 March of Dimes Foundation. The March of Dimes is a non-profit organization recognized as tax-exempt under Internal Revenue Code section 501(c)(3).