Heather Winter was instrumental in undertaking the initial analyses, but died before the later drafts of the manuscript were completed.
The role of a maternity waiting area (MWA) in reducing maternal mortality and stillbirths in high-risk women in rural Ethiopia
Article first published online: 7 SEP 2010
© 2010 The Authors Journal compilation © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 117, Issue 11, pages 1377–1383, October 2010
How to Cite
Kelly, J., Kohls, E., Poovan, P., Schiffer, R., Redito, A., Winter, H. and MacArthur, C. (2010), The role of a maternity waiting area (MWA) in reducing maternal mortality and stillbirths in high-risk women in rural Ethiopia. BJOG: An International Journal of Obstetrics & Gynaecology, 117: 1377–1383. doi: 10.1111/j.1471-0528.2010.02669.x
- Issue published online: 7 SEP 2010
- Article first published online: 7 SEP 2010
- Accepted 14 May 2010. Published Online 29 July 2010.
- maternal mortality;
- maternity waiting area;
Please cite this paper as: Kelly J, Kohls E, Poovan P, Schiffer R, Redito A, Winter H, MacArthur C. The role of a maternity waiting area (MWA) in reducing maternal mortality and stillbirths in high-risk women in rural Ethiopia. BJOG 2010;117:1377–1383.
Objective To describe maternal mortality and stillbirth rates among women admitted via a maternity waiting area (MWA) and women admitted directly to the same hospital (non-MWA) over a 22-year period.
Design Retrospective cohort study.
Setting Hospital in rural Ethiopia, which provided comprehensive emergency obstetric care and has an established MWA.
Population All women admitted for delivery between 1987 and 2008.
Methods Data on maternal deaths, stillbirths, caesarean section and uterine rupture were abstracted from routine hospital records. Sociodemographic characteristics, antenatal care and other data were collected for 2008 only. Rates and 95% confidence intervals were calculated for maternal mortality and stillbirth.
Main outcome measures Maternal mortality and stillbirth.
Results There were 24 148 deliveries over the study period, 6805 admitted via MWA and 17 343 admitted directly. Maternal mortality was 89.9 per 100 000 live births (95% CI, 41.1–195.2) for MWA women and 1333.1 per 100 000 live births (95% CI, 1156.2–1536.7) for non-MWA women; stillbirth rates were 17.6 per 1000 births (95% CI, 14.8–21.0) and 191.2 per 1000 births (95% CI, 185.4–197.1), respectively; 38.5% of MWA women were delivered by caesarean section compared with 20.3% of non-MWA women, and none had uterine rupture, compared with 5.8% in the non-MWA group. For the 1714 women admitted in 2008, relatively small differences in sociodemographic characteristics, distance and antenatal care uptake were found between groups.
Conclusions Maternal mortality and stillbirth rates were substantially lower in women admitted via MWA. It is likely that at least part of this difference is accounted for by the timely and appropriate obstetric management of women using this facility.