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When governments cut health spending, more women die in childbirth

Though the presence of a skilled childbirth specialist can help.

Image: Shutterstock/Kumpol Chuansakul

A REDUCTION IN spending on health has seen the European rate of deaths during childbirth go up.

That is the suggestion of a new paper published today in BJOG: An International Journal of Obstetrics and Gynaecology (BJOG).

However, if skilled birth attendants are in place, the associated risk disappears, highlighting the potential importance of maternal care, the research finds.

The study looks at the association between reductions in government healthcare spending (GHS) and maternal mortality across the European Union (EU) over a 30 year period from 1981 to 2010.

Maternal mortality is defined as the death of a woman during pregnancy, childbirth, or within 42 days of delivery from direct obstetric causes.

GHS is the total expenditure on health care by a government measured as a percentage of gross domestic product (GDP).

The study found that for every 1% decrease in government healthcare spending, EU countries experienced an average 10.6% annual increase in maternal mortality. This association also remained significant for one year after the spending cut.

Moreover, the study found that the association remained significant after accounting for economic, infrastructure and hospital resource controls, in addition to out-of-pocket expenditure, private health spending and the total fertility rate.

However, when accounting for the percentage of births attended by skilled health professionals, defined as people trained to give the necessary supervision, care and advice to women during pregnancy, labour and the postpartum period, the effect is no longer significant.

Professor Thomas Zeltner of the University of Bern, Switzerland, who is the co-author of the paper said:

With reduced government spending in this area in times of austerity, policy makers need to be aware of the consequences of the budget cuts. If cost-reductions are matched by sufficient increases in efficiency, quality of care may remain.
Our results suggest that reductions in government healthcare spending are associated with increased maternal mortality rates in the EU. This may occur due to a variety of reasons such as reductions in the number of births attended by skilled health professionals.

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