Birth mortality rates – let’s get real

A sad, frustrating article was published to the public two days ago. Myself and fellow birth educators and birth experts were appalled at the inaccuracies and the fear mongering.

It is so upsetting, as we know that fear negatively affects birth.

Is journalism so sensationalist that it would propagate fear?

Wait, don’t answer that 🙁

IF you believed what you read in that paper? Claire Harvey is claiming to her audience that “half of all women and half of all babies used to die in childbirth”.

I was so glad to see Tanya Strusberg from BirthWell Birthright quickly write and publish an excellent response to Claires’ article.

Except, I was enjoying Tanyas’ article and then THAT sentence jumped out at me AGAIN! With Tanya stating: “However, in 1900, childbirth was to be legitimately feared. Almost half of all women would not survive birth“.

Okay, that myth has got to be debunked. That myth has become so deeply ingrained in society that even the most educated and passionate about birth can pass over it.

My investigation into the myth:

For perspective lets first acknowledge that Australias’ current mortality rate is extremely low at 7.1 deaths per 100,000. If we’re to believe that ‘half of women used to die in childbirth’ then that literally means that, at some time in history, childbirth was so dangerous it killed 50,000 per 100,000 women ?!??!

If you take the time to reflect on that (if you have the time – like me sitting at home with a newborn)- it makes NO sense at all. If half the women died, then the next year when most fertile women fell pregnant again, half of THEM would then also die. And the next year when again most fertile women fell pregnant again, then half of THEM would die. It would be very quick before there were no fertile women left! The young girls maturing to a fertile age would not be able to get there quick enough to continue the population onwards.

So, being a bit obsessive with birth matters, I set to researching.

In Barbara Hanawalts’ book “Growing up in Medieval London” On pages 43 and 234, the author cites 1,440 maternal deaths for every 100,000 births in 15th century Florence.

I found a very well referenced and researched article discussing rates around the early 1900’s. It looked at records from England and Wales from about the 1850s to 1937 and described mortality as “high” and staying at a steady rate in those years. They described the mortality at that time as much as “50 times higher than now”. Developed countries currently have 12 per 100,000 so I multiplied this by 50, and got a rate of 600 per 100,000.

The work by Wrigley and Schofield, who wrote a “population history of England” [Cambridge: Cambridge University Press, 1981] found maternal mortality rates were at ≈400–500 per 100,000 births throughout the 19th century. They state “it was a bit higher at the beginning of the 19th century and was up to perhaps 1,000 per 100,000 births in the early part of the 18th century”.

Here’s another quote from another writer discussing medieval history: “In fact, more than one of every three adult women died during their child-bearing years”. Notice how scary this sounds at first? If you break down this statement, it’s not so scary. If one woman in three will die “in her childbearing years” this could mean just anywhere between the ages of 14 and 45. It doesn’t mean that during birth a third of all women died.

It helped me see where the myth could come from.

Another article discussed that around 1620 “a woman’s chances of dying during childbirth were between one and two percent for each birth”. So mortality rates as high as 2,000 per 100,000.

None of these historians mention any mortality rate near 50,000 per 100,000. (thank goodness, otherwise birth really would be extremely dangerous and scary).

What about current mortality in developing countries? Where there is barely any obstetric or midwife support at all. Where water and nutrition are scarce. Where many populations are diseased or overcrowded. What is the mortality rate there?

In 2015 the maternal mortality ratio in developing countries was 239 per 100 000.

So next time you see the sentence: “half the women used to die childbirth”, be careful not to allow this to go unquestioned. If we don’t consciously question grossly inaccurate statistics – then we stand to accidently continue to perpetuate the negative myths and fears of childbirth.

My belief system is that if you go back in history far enough, you’ll find good survival rates. And its easy to prove my theory – just look at how well humans populated each corner of every continent many thousands of years ago.

Trust your body, it knows how to birth. Women have been doing it for millions of years.

pregnancy newcastle

FINAL NOTE: When childbirth was causing a lot of death it was due to two particularly large medical errors, including using metal instruments to interfere with birth and cause sever post partum haemorrhage and also, childbed fever, where doctors used dirty, infection exposed hands to then attend a woman in birth.