Main description:

One of the most dramatic changes to women's lives in the twentieth century was the advent of safe childbirth, reducing the maternal mortality rate from 1 in 400 births to 1 in 10,000 in just 80 years. The impetus behind this change was the Confidential Enquiries into Maternal Death (CEMD), now the world's longest running self-audit of a healthcare service. Here, leading authors in the CEMD tell the story of the pioneering clinicians behind the push for improvements, who received little recognition for their work despite its far-reaching consequences. One by one, the leading causes of maternal death were identified and resolved, from sepsis to safe abortions and more recently psychiatric illness and social and ethnic disparities in healthcare. Global maternal mortality is still too high; this valuable book shows how significant advances in maternal healthcare are possible when clinicians, politicians and the public work together.

Contents:

1. Historical background; 2. The first steps: 1900-1939; 3. How the confidential enquiries evolved; 4. The missing chapter? Prolonged labour and obstetric trauma; 5. How the change began: the story of sepsis; 6. Haemorrhage then and now; 7. Hypertension: enquiries, trials and recommendations; 8. The story of abortion; 9. Challenging tradition: the story of embolism; 10. Pregnancy and illness: indirect deaths; 11. Maternal death due to anaesthesia; 12. Psychiatric illness; 13. The mothers who died: the social deteminants of maternal deaths; 14. The legacy in the UK: the concept of 'near miss' and the need to keep saving lives; 15. International maternal health: global action; 16. International action: personal views.