Public Health Achievements
Healthier Mothers and Babies
In the United States one hundred years ago, it was considered to be quite
common for a mother to die of pregnancy-related complications. It happened in about 1% of
the births. This was 100 deaths per 10,000 pregnancies. It was even more common for an
infant to die. About 10% of the infants (1,000 of every 10,000 births) died before they
reached the end of their first year.
During this 20th century, the maternal mortality rate has declined almost 99% as there are
now fewer than 1 reported maternal death for every 10,000 live births. The infant
mortality rate has also significantly declined. There are now about 70 infant deaths
reported during the first year of life for every 10,000 live births. That is greater than
a 90% improvement.
The prime approach used by the public health community in their efforts to prevent the
early death of newborns focused on improving environmental and living conditions in urban
areas. Sewage systems, refuse disposal, and safe drinking water played key roles in
achieving this major reduction of infant mortality.
Poor obstetric education and delivery practices were found to be the main reason for the
high numbers of maternal deaths. Prevention efforts focused on improving the training of
professionals, improving the maternal care in general, and improving the knowledge and use
of aseptic (germ-free) principals in all delivery settings. The increased use of hospital
settings for deliveries has also been credited with reducing maternal mortality rates.
(Achievements in Public health, 1900-1999: Healthier Mothers and Babies; MMWR; Vol 48(38),
October 1, 1999)
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