The final stage of a woman's pregnancy usually ushers in a mixed feeling of joyful anticipation and fear, not just for the woman, but even for the father-to-be. Many first-time parents experience major attacks of anxiety as the labor and delivery day approaches. It's a time when realistic concerns seem overwhelming: the dread of experiencing labor pain and, for some who have a very delicate pregnancy, even the possibility of death.



While it was generally thought that the risk of death from childbirth was very small, recent records show a rise in the risk of death especially for women suffering from maternal obesity and those who had to undergo Caesarean sections. Deaths from childbirth were a much more common tragedy 90 years ago when nearly one in every 100 live births resulted in a mother's death. However, many people find it hard to understand how in this age of high-tech hospital facilities and advanced medical knowledge that maternal deaths could still occur.

The current C-section incidence rate is at 29 percent of all births, far higher than what public health experts say is normal. These experts are not too keen in seeing a further rise on C-sections because the said procedure also exposes women to potential side effects of anesthesia, infections, and blood clots. Excessive bleeding, too, has been identified as a leading cause of pregnancy-related death. This is followed closely by the number of cases where the woman giving birth experiences blood vessel blockages and infections. Women with several previous C-sections are at an even higher risk for complications the next time they undergo the procedure.

Obesity can also be a factor, according to medical experts, since heavy women are more prone to diabetes and other complications. Having excess tissue and large babies can make a vaginal delivery more problematic that may lead to more C-sections.

Another factor that heightens the risk of pregnancy-related deaths is the age of the mother. More women are giving birth in their late 30s and 40s, when risk for complications become greater.

Other important facts about maternal mortality include:

Race: Studies have found that the maternal death rate in black women is at least three times greater than it is for whites. Black women are more susceptible to complications like high blood pressure and are more likely to get inadequate prenatal care.

Quality of care: Three different studies indicate at least 40 percent of maternal deaths could have been prevented.

There are times when there is no clear explanation for a woman's death, such as the case of Valerie Scythes, a 35 year-old elementary schoolteacher who died after a C-section at a hospital in New Jersey, the state known for its highest Caesarean section rate. Two weeks later, another teacher at the same school died at the same hospital after a C-section delivery. While Scythes died of a blocked blood vessel, the other woman died from bleeding. The connection between the two deaths had not been clearly established.

Another mysterious case of maternal death was that of Elizabeth Davis, 37, who died of a heart attack after a massive loss of blood a day after a vaginal delivery at a Danville, Virginia hospital in September 2000. The cause of heavy bleeding was not clearly known. Tim, the husband, regretted his failure to have an autopsy done on Elizabeth. He did not believe that anything could go wrong with the pregnancy because he said that his wife was healthy and had undergone two previous births quite well. A lawsuit against the hospital ended in a settlement.

These cases only highlight the need for more information and awareness about the possible links of obesity to difficuly or even fatal pregnancies and childbirths.