Maternal mortality trend in Goa: a record-based study

Abstract

Background: Maternal mortality reflects unequal access to quality health services across the world. Despite a consistent decline in deaths, disparities between states could hinder our progress towards Sustainable Developmental Goals. Maternal Death Reviews were introduced nationwide to address causative aspects of maternal deaths and take corrective actions. This study was devised to assess the maternal mortality trend over a 10-year period and to determine cause-specific distribution of mortality across Goa. Methods: A retrospective study was conducted using Facility reviews and Verbal Audit forms of reported maternal deaths from 2016 to 2025. All 125 reports were analysed for sociodemographic data, antenatal factors and cause of death using SPSS v.14. Results were presented as frequency, percentages, figures and graphs. Results: Out of 125 deaths, 103 (82.4%) were indigenous. Among these, 24 (23.3%) were graduates, 44 (42.7%) were above poverty line, 12 (11.6%) conceived with in-vitro fertilization and 82 (79.6%) were from rural Goa. Ten (7.7%) mothers died without antenatal care and 61 (59.2%) died postnatally. Haemorrhage (22.3%), hypertension (21.4%), other infective causes (17.5%) and cardiovascular causes (15.5%) caused the most indigenous deaths; these were primarily concentrated among <35 years old (67%), South Goa (56.3%), Goa Medical College (74.8%) and in 2018 (16.5%). Conclusions: Though Goa provides commendable obstetric care, equipping all healthcare levels equally to handle any obstetric case before it becomes a tragedy needs prioritizing. Continuing MDSR with responsibility rather than blame, robust counselling of expectant mothers especially at IVF centres and a prompt referral system could help.