Maternal mortality: an overlooked tragedy.

The authors describe the maternal health situation and some of its determinants in Latin America and the Caribbean. They rely upon official mortality statistics supplemented with other information sources to analyze the levels structure differentials and determinants of morbidity and mortality due to complications of pregnancy delivery and the puerperium stressing how the problem can be avoided and the issues relationship with social factors. The paper is presented by section on maternal mortality maternal morbidity and the role of health services although aspects related to mortality are emphasized. The paper first discusses the avoidability of maternal mortality then reviews the current situation and trends of maternal mortality in terms of the social context of maternal mortality the quality of information population at risk the situation and trends in the Americas; the influence of social cultural geographic and individuals factors in maternal mortality differentials; and the structure of maternal mortality by cause. Maternal morbidity is then discussed with regard to hospital-related maternal morbidity morbidity during the prenatal period and morbidity during delivery and the postpartum period followed by a section on maternal health services: maternal care coverage service quality family planning services and the cost of maternal mortality prevention services. The authors conclude that maternal mortality and morbidity in most of the region are the principal health problems of women of reproductive age in individual family and social terms. It is highly probable that the majority of mortality occurs in the marginal populations of large urban concentrations and in rural areas. Although Latin American and Caribbean countries are 35-90 years behind more developed states and countries with low maternal death rates improving the social condition of women and appropriate health technology should be able to close the gap within one decade.