Maternal Deaths in Washington State

To determine the completeness of maternal death reporting in Washington State computerized death data files were used to compile a list of selected death certificate information for 1350 women who died from causes other than cancer accident suicide or homicide over the 1977- 81 period. The name lists of deceased women (or their spouses) were matched manually to the birth-fetal death index to determine if a birth or a fetal death occurred within 1 year before the death. 45 women who died were identified as having a birth or fetal death during the year before their death. 35 had matching birth certificates 3 had matching fetal death certificates and 7 listed maternal conditions as the cause of death but no matching birth or fetal death certificate could be located. 36 of the 45 identified deaths were classified as maternal deaths. 17 (47%) of these deaths were previously identified on the death certificate as pregnancy related; pregnancy was not listed as a primary or secondary diagnosis on the death certificate in the remaining 19 deaths demonstrating significant under reporting of maternal mortality. Hypertensive disorders and pulmonary embolism were the major causes of death.