Maternal mortality: preventing the tragedy in developing countries.

Maternal mortality in childbirth has been, until recently, a neglected tragedy in most developing countries. Rates of maternal deaths range from 300 to 700/100 000 live births, from 50 to 100 times greater in developing than in developed countries. The major direct obstetric causes include illegal abortions, hemorrhage, sepsis, obstructed labour, ruptured uterus, and pregnancy-induced hypertension. During the past decade, increased recognition of this problem has led to the "Safe Motherhood Initiative" by the World Health Organization in 1987, which has been integrated into the goal of "Health for All by the Year 2000." The training of traditional birth attendants (who attend from 40% to 60% of births in developing countries) is seen as one of the most important ways to improve obstetric care in remote rural villages.