A 10-year review of maternal mortality in a municipal hospital in Rio de Janeiro: a cause for concern.

A 10-year review of maternal mortality was conducted at the Municipal Hospital Miguel Couto in Rio de Janeiro. Thirty-two deaths occurred between January 1978 and December 1987. In the same period there were 18,071 live births, giving an overall maternal mortality ratio of 177 per 100,000 live births. Maternal mortality increased from 128 per 100,000 live births in 1978 to 462 per 100,000 in 1987. Abortion-related deaths accounted for 47% of the total mortality, followed by toxemia (19%) and hemorrhage (13%). The contribution of abortion-related mortality to maternal mortality increased 172% over the 10-year period studied. These results indicate that maternal mortality has been increasing in a population of urban poor and that the leading cause of death is induced abortion. In a setting where access to abortion is highly restricted and desire to regulate fertility is high, death due to illegal abortion is a major contributor to maternal mortality. The rise in abortion-related mortality over the past 10 years is attributed to a lack of family planning services in conjunction with urban socioeconomic conditions conducive to smaller families.