Maternal deaths in Australia 2018-2020

In Australia, most women have healthy pregnancies. However, while it is rare, sadly some women die during pregnancy or in the postpartum period. All these deaths are reviewed by health professionals to determine the likely cause and whether the pregnancy contributed to the death.

This report focuses on the women who died during pregnancy or within 42 days of the end of pregnancy, regardless of duration, from any cause related to or aggravated by the pregnancy or its management. These are called ‘maternal deaths’. Maternal deaths do not include deaths by accident or other incidental causes.

It is important to understand how often and why maternal deaths happen. Data on maternal deaths can help policymakers and healthcare providers better understand what can be done to ensure mothers stay healthy through pregnancy and beyond.

As maternal deaths are very rare in Australia, this report combines data over a 3-year period (1 January 2018 to 31 December 2020) to allow for more detailed reporting and analysis of maternal characteristics.

The maternal mortality ratio has more than halved since the 1970s

Between 2018 and 2020, about 889,000 women gave birth and there were 63 deaths. Of these, 50 were considered maternal deaths (that is, related to the pregnancy) and 13 were coincidental to the pregnancy. This is a maternal mortality ratio (MMR) of 5.6 deaths per 100,000 women giving birth in 2018–2020 and is the lowest MMR recorded since comparable definitions were introduced in 1973–1975, when the rate was 12.7 per 100,000.

Cardiovascular conditions are one of the leading causes of maternal death

The most common causes of maternal deaths in 2018–2020 were cardiovascular conditions, thromboembolism (blood clots in the veins) and sepsis (8 deaths each).

In 22 of the 50 maternal deaths, factors contributing to the death were identified. The most common factors were grouped as professional care (such as inadequate staffing, failure or delay in emergency response, failure to offer or follow recommended best practice) (12 deaths) and factors relating to the individual, family or social circumstances (for example insufficient or no antenatal care, substance abuse and family violence) (10 deaths).

SARS-COV-2 (COVID-19) infection was not reported as the cause of death for any maternal deaths during 2018-2020.

Some women are at greater risk

The MMR is higher among some groups of women. These include women who:

• have given birth 4 or more times (an MMR of 23.9 per 100,000 women giving birth, or 7 deaths)
• are aged 35 and over (an MMR of 11.7, or 26 deaths)
• smoked in the first 20 weeks of their pregnancy (an MMR of 12.5, or 10 deaths)
• identify as Aboriginal and Torres Strait Islander (an MMR of 9.4, or 4 deaths).

While every death is a tragedy, it is important to remember that maternal deaths are rare, even among these groups. Care should be taken when interpreting these data due to the very small numbers.

The Maternal deaths in Australia series documents 56 years of continuous maternal mortality monitoring in Australia.