A 10-year review of maternal mortality in a municipal hospital in Rio de Janeiro: a cause for concern.

A 10-year review of maternal mortality was conducted at the Municipal hospital Miguel Couto in Rio de Janeiro. 32 deaths occurred between January 1978-December 1987. In the same period there were 18071 livebirths giving an overall maternal mortality ratio of 177/100000 livebirths. Maternal mortality increased from 128/100000 livebirths in 1978 to 462/100000 in 1987. Abortion-related deaths accounted for 47% of the total mortality followed by toxemia (19%) and hemorrhage (13%). The contribution of abortion-related mortality to maternal mortality increased 172% over the 10-year period studied. These results indicate that maternal mortality has been increasing in a population of urban poor and that the leading cause of death is induced abortion. In a setting where access to abortion is highly restricted and desire to regulate fertility is high death due to illegal abortion is a major contributor to maternal mortality. The rise in abortion-related mortality over the past 10 years is attributed to a lack of family planning services in conjunction with urban socioeconomic conditions conducive to smaller families. (authors)