ABSTRACT
Though not usually a forensic problem, deaths associated with pregnancy (other than criminal abortions) are a major health problem worldwide; however, these are decreasing from an estimated 536,000 deaths in 2005 to 289,000 in 2013. Identification of the true numbers of maternal deaths is difficult due to differences in medical certification of causes of death. Even in developed countries they are often under-reported and special investigations may be necessary to elicit the true numbers.1,2
In Britain, the concern about the persistently high level of maternal mortality led first to major local enquiries into maternal deaths in Scotland, England and Wales in the 1920s and 1930s; from 1952 onwards the Department of Health has had a nationwide ongoing ‘Confidential Enquiry into Maternal Deaths (CEMD)’, now carried out by the Centre for Maternal
and Child Enquiries (CMACE), publishing valuable reports at 3-yearly intervals that have helped to clarify both the clinical and pathological aspects of the problem. A recent such investigation in the UK identified 261 maternal deaths in comparison to the 155 deaths reported in the routine civil registration system.3
