Characteristics of Obstetric Near-miss Cases in Indonesia

Maternal mortality remains a public health burden. However, studies on maternal death are mostly challenged by the difficulty in 'capturing' the cases, which could largely be missed by the health system. Obstetric nearmiss, which refers to survived woman who went through life-threatening complications, has been suggested to complement maternal death investigation. The present study is a retrospective analysis aimed to describe the characteristics of obstetric near-miss. Data on obstetric admissions in 2005-2006 were collected from two public hospitals in Indonesia (n=1.840). We identified 378 obstetric near-misses; 67% of them had suffered the life-threatening conditions when arrived at the hospitals. The majority of the near-miss cases were from rural/remote areas (65.8%), and more than half were beneficiaries of insurance for the poor (56.6%). More than one-third of the cases were aided by traditional-birth-attendants before arriving at the hospital (38.6%). Women living in rural/remote areas and those of low socio-economic were disproportionately affected by the maternal health problem. The study indicates that delay in seeking care may largely contribute to nearmiss cases. Characteristics of the near-miss cases were consistent with those of maternal deaths in general, suggesting near-miss is appropriate to serve as a proxy of maternal death.