Pregnancy delays linked to maternal deaths

Senior Medical Officer at Victoria Jubilee Hospital (VJH), Dr Garth McDonald, says delaying their pregnancy, obesity, as well as chronic illnesses, hypertension and heart disease are the major factors contributing to the country's high maternal mortality rate (MMR).

The MMR measures the number of maternal deaths that occur per 100,000 live births during a specific time period, typically a year. Maternal deaths are those caused by complications from pregnancy, childbirth, or within 42 days of delivery, excluding deaths from incidental or accidental causes.

Since 2016, Jamaica's maternal mortality ratio has remained above 100 per 100,000 live births. The highest rate was reported in 2021, with 211.3 deaths per 100,000 live births. In 1990, the maternal mortality ratio was 110 per 100,000 live births. Jamaica had agreed a Millennium Development Goal of reducing maternal mortality rate to 26.5 per 100,000 live births by 2015.

McDonald, in an interview with THE WEEKEND STAR, said the numbers at his institution are heading in the right direction.

"For our institution, in terms of numbers, we're actually decreasing. But as the birth rate decreases, then the denominator significantly decreases, and that significantly impacts the overall maternal mortality ratio," McDonald explained.

He highlighted that there were approximately 6,001 deliveries in 2023, compared to roughly 5,200 deliveries in 2024. Despite this decline, McDonald noted that several factors could potentially lead to an increase in maternal mortality.

"We are hoping that the trend will continue downwards, but based on changes within the population in terms of women delaying their fertility, obesity, and other chronic illnesses -- hypertension, heart disease -- we could see an increase in the denominators," McDonald said.

McDonald acknowledged that poor patient care plays a role in avoidable maternal deaths, especially when there are no other underlying health complications.

"If there are any shortcomings within the institution, any gaps along the way, those could impact on the overall outcome. But our role as birthing hospitals is to identify the gaps and work closely with the statisticians at all levels to reduce these gaps," McDonald said, adding that efforts are ongoing to address the issues.

"From the local hospital level to the regional level to the Ministry of Health, every effort is made to identify and lessen the gaps that could result in maternal mortality. But the patient also has a role," McDonald said, stressing the importance of patient education and compliance in reducing maternal deaths.