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I IN TAM MPH H HEALTH RES TH SEARCH CEN CH NTR GEO OGR AP PICA INFORM AL RATIO ON SAYS STEMS (GIS UNI S) IT TH GEOG HE GRAPHICAL INFORM L MOTION SY SYSTEMS UN NIT The Geography he hical Inform action

The field work included the study of pregnant women in four study regions of the United States under different socioeconomic conditions. The study has been undertaken in an effort to provide more than just the information that the ITA will provide. The project aims to provide an in depth analysis of maternal mortality and other environmental causes of disease. This effort began in early May 1982, and is now near completion. The study and the analysis was initially planned to develop an integrated, unified and inter lived analytical method which would produce a summary and analysis for use for the Federal Government. We are now almost a third of the way toward this goal. One of the most exciting aspects of the analysis has been the discovery of new and novel causes of maternal death which cannot be predicted or controlled. This aspect was made all the more spectacular by the appearance of the first cause of death identified, death from hemorrhage in a woman who was known to have had a prior spontaneous abortion. For the purpose of analysis, the most common cause of death print ant for pregnant women in any given study region is hemorrhage. A full list of the causes of mother death are below the picture. The other, unknown causes of death are listed in a separate list. We cannot estimate the total number of deaths from unknown causes but estimate that it is a small part of total deaths. We now believe that the most important factor affecting the rate of maternal deaths is not the total number of deaths but the distribution of deaths. Mothers who have the most children, live in the most vulnerable areas and are least likely to have the resources to survive the birthing experience. The total number of deaths in the study is likely to be the result of individual and group death patterns that result from poor quality, poorly planned and administered prenatal care. At any given time, it is quite possible that a mother does not have a pregnancy, but she has had a history of having miscarriages, abortions or still births. If this information is not documented, the cause of death is never recorded in the statistics. Other maternal deaths were also found but, on further examination, they did not seem to be related to miscarriage. The maternal mortality rate is an imprecise statistic but was found to be fairly accurate. The death data had a standard deviation not very different from that of the standard deviation of pregnancy rates. This means that there is no systematic bias in what is reported.

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