UK Stats: Deaths during "Pregnancy, childbirth and the puerperium"

I was fairly surprised how badly the UK fares in the Cancer Mortality statistics compared to our continental and Transatlantic cousins. So when I heard that some UK hospitals were reputed to have a very poor comparative record for maternal survival rates, I thought it might be informative to dig out the national numbers, given I had the spread sheet downloaded already.

Basically, the Office of National Statistics collates data from the causes of death as certified by a doctor or coroner and releases the data periodically. Typically there is good quality coverage in the UK, and the data is classified using ICD-10 disease codes for helpful comparative purposes. The last full year was 2010, for the which the data was released in Oct-2011.

So the head-line numbers for this rather unfortunate way to perish are as follows;

Of the 236,732 women whose deaths were registered in 2010 there were 35 for whom the final cause of death was recorded in the category "Pregnancy, childbirth and the puerperium".  (Def. "puerperium" Medline)

The absolute counts of deaths (other age segments are zero):

TotalUnder 11-45-910-1415-1920-2425-2930-3435-4940-44

XV Pregnancy, childbirth and the puerperiumF 35----23121233

With regard to comparison between nations, its inappropriate to use the raw numbers, or even crude rates because of the variations of age-distribution and gender-distribution.

The ONS use a process (@todo link) of direct standardization which rescales crude rates to a "model" European population. From my reading on the sources on the web (blogs, reviews etc) it is considered somewhat out of date, hence the resulting numbers are of more use comparatively than than as a headline number.

However the age-adjusted mortality rate table is as follows;

ICD-10 Codeunderlying cause
TotalUnder 11-45-1415-2425-3435-44
O00-O99XV Pregnancy, childbirth and the puerperiumF1---172

As a person with absolutely no knowledge of maternity, or child birth I still feel slightly entitled to be surprised for a couple of reasons, such as
  1. The absolute low numbers of maternal deaths.
  2. That the age-standardized rate is higher for 25-34, than for 35-44.
Just intuitively child-birth looks like a pretty traumatic event, both psychologically, and by the count of stitches required in the fairly gross-out descriptions I have heard of some examples, so 35 maternal deaths from 723,165 live births seems surprisingly low.

I guess correcting for the fertility rate differential between the 25-34 and the 35-44 age-segments would make that comparison of those values more useful. So I will make a @todo for when I find the fertility by age-segment table.

But a 24-34 year old seems much more likely to commit suicide, die of cervical cancer, or literally die of very many other things.

The records for perinatal and neonatal deaths are in another series. But its worth mentioning that the 2010 infant mortality rate is the lowest ever recorded in England and Wales (4.3 deaths per 1,000 live births).

Another summary point is that the general 2010 mortality rates for both males and females were the lowest ever recorded in England and Wales.

Hence I like to have those 2 findings available for anyone who suggests that the NHS is "going downhill".

You know, I can concede various points like "It's not going uphill as fast as similarly wealthy, comparable nations", but not "going downhill"

p.s. Those numbers are so low, that I suspect I have read the numbers wrong somehow, so don't quote this blog, because it might be wrong.

Definition of "puerperium" from Medline.
"the period between childbirth and the return of the uterus to its normal size"