MATERNAL,

MORBIDITY,
MORTALITY AND
FERTILITY RATES
Presented by
Madhu.B
Lecturer
Department of OBG
Sarvodaya college of nursing
Bangalore
 MATERNAL MORBIDITY
• Morbidity has be e n defi ned as “any departure, subjective or
objective, from a state of physiological well being” .
• The problem is equivalent to such te rms as sickness , illness,
disability etc. The W H O Expert committ ee o n Health Statistics
n ote d in its 6 t h report t h a t morbidity could be measured in
terms of 3 units-
a. person who ill ;
b. the illness that these persons experienced and
c. the duration of these illness.
MATERNAL MORBIDITY
• Obstetric morbidity originates from any cause related to pregnancy or its

management any time during antepartum, intrapartum and postpartum

period usually up to 42 days after confinement. The parameters of maternal

morbidity

1.Fever more than 100.40F or 380C and continuing more than 24 hours.

2. Blood pressure more than 140/90 mm of Hg

3.  Recurrent vaginal bleeding

4.  Hb% less than 10.5 gm irrespective of gestational period.

5. Asymptomatic bacteriuria of pregnancy.

 CLASSIFICATION

1.   Direct Obstetric Morbidity

a.    Temporary

b.   Permanent

2.   Indirect Obstetric Morbidity

 CLASSIFICATION
1) Direct Obstetric Morbidity
• Temporary
• APH, PPH, Eclampsia, obstructed labour, rupture,
sepsis, ectopic pregnancy, molar pregnancy etc
• Permanent (Chronic)
• VVF, RVF, dyspareunia, CPI, prolapse secondary
infertility, obstetric palsy.
 CLASSIFICATION

2) Indirect Obstetric Morbidity

These conditions are only expressions of

aggravated previous existing disease like malaria,
hepatitis, tuberculosis, anaemia etc by the changes
in the various systems during pregnancy.
Reproductive Morbidity:
Reproductive morbidity is used in a broader sense
to include
• a.    Obstetric morbidity
• b.   Gynaecological morbidity
• c.    Contraceptive morbidity
 FERTIFILITY RATE

• By fertility is meant the actual bearing of children. A

woman’s reproductive period is roughly from 15-45
years – a period of 30 years. A women married at 15
and living till 45 with her husband is exposed to the
risk of pregnancy for 30 years and may give birth to
15 children, but this maximum is rarely achieved.
 CAUSES

• The higher fertility in India is attributed to universities of

marriage.

• Lower age at marriage

• Low level of literacy

• Poor level of living

• Limited use of contraceptives and traditional ways of life

 FACTORS AFFECTING
1. Age at Marriage

The age at which a female marries and enters the

reproductive period of life has a great impact of her
fertility. The registrar general of India collected data
on fertility on a national scale and found that female
who marries before the age of 18 gave birth to a larger
number of children than those who married after 20.
 FACTORS AFFECTING
2. Duration of Married Life

Studies indicate that 10-25 percent of all birth occur within 1-5 years
of married life. Births after 25 years of married life are very few (20)

3. Spacing of children

Studies have shown that when all births are postponed by one year,
in each age grouse there was a decline in total fertility. He follows
that spacing of children may have a significant impact on the general
reduction in the fertility rates.
 FACTORS AFFECTING

4. Education

There is an inverse association between fertility and

educational status. The national family health survey-3
show that the total fertility rate is 1.7 children higher for
illiterate women than for women with at least a high
school education.
 FACTORS AFFECTING
5. Economic status

Operational research studies support the by pothesis that

economic status bears an inverse relationship with fertility. The
total number of children born declines with an increase in per
capita expenditure of the household. The world population
conference at Bucharest in fact stressed  that economic
development is the best contraceptive. It will take care of
population growth and bring about reductions in fertility.
 FACTORS AFFECTING
6. Cast and Religion
Muslim has a higher fertility than Hindus. The national family health survey
– 3 reported a total fertility rate of 3.09 among Muslims are compared to
265 among Hindus.
The total fertility rate among Christians was found to be 2.35. Among
Hindus, the lower castes seem to have a higher fertility rate than the higher
castes.
7. Nutrition
    There appears to be some relationships between nutritional status and
fertility levels virtually all well fed societies have low fertility and poorly fed
societies high fertility. The effect of nutrition on fertility is largely indirect.
 FACTORS AFFECTING

8. Family Planning

•         Family planning is another important factor in

fertility reduction. In a number of developing countries,
family planning has been a key factor in declining
fertility. Family planning programmes can be initiated
rapidly and require only limited resources, as compared
to other factors.
 FACTORS AFFECTING
9. Other Factors

•         Fertility is affected by a number of physical, biological, social

and cultural factors such as place of women in society, widow
remarriage, breast-feeding, customs and beliefs, industrialization
and urbanization, better health conditions, housing,
opportunities for women and local community involvement.
Attention to these factors requires long term government
programmes and vast sum of money.
Thank you
 BIBLIOGRAPHY
• http://silverlineservices.blogspot.com/2015/12/ma
ternal-mortality-morbidity-rate.html
• https://www.slideshare.net/bkpraseeda/maternal-
mortality-68325631
• https://www.slideshare.net/ArvindKushwaha1/mm
r-ug
•  D.C.Dutta, “A Text Book of Obstetrics”, 6th Edition,
Page No.644-648.
•  Myles, “A Text Book of Midwives”, 13th Edition,
Page No.933-935.
•  K.Park, “A Text Book for Community Health
Nursing”, Page No.416-419.