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Death Certificates

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Death certificates are vital records which document the medical causes and circumstances of all deaths. A standard death certificate form asks for primary and underlying causes of death, which may or may not capture those related to pregnancy. As a result, even in settings where vital records are routine and complete, pregnancy-related deaths may be missed. A Modified Death Notification Form, which includes additional questions and tick-boxes related to pregnancy, is preferable. Please see the sample death certificates below from the United Kingdom (does not include pregnancy-related questions) and the USA (a modified death notification form) for examples.

In some settings, such as South Africa, a separate Maternal Death Notification Form (MDNF) is used. This supplements a standard death certificate with more detailed information about the circumstances of a maternal death. See below for a sample MDNF.

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Centers for Disease Control and Prevention Instructions for Classifying the Underlying Cause-of-Death, ICD-10, 2007

Centers for Disease Control and Prevention Instructions for Classifying the Multiple Causes of Death, ICD-10, 2007

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Obstetrics and Gynecology Harper, M; Parsons, L (1997) Maternal Deaths Due to Homicide and Other Injuries in North Carolina: 1992-1994 - A forty-year experience. Obstetrics and Gynecology; 90(6): 920-3.
Identifies maternal deaths solely through death certificates.

American Journal of Public Health Horon, IL (2005) Underreporting of maternal deaths on death certificates and the magnitude of the problem of maternal mortality. American Journal of Public Health, 95(3): 478-82.

National Center for Health Statistics Hoyert DL (2007) Maternal mortality and related concepts. National Center for Health Statistics. Vital & Health Statistics 3(33).

Elsevier - American Journal of Preventive Medicine MacKay AP, Rochat R, Smith SC, Berg CJ. (2000) The check box. Determining pregnancy status to improve maternal mortality surveillance. American Journal of Preventive Medicine; 19: 35-39.

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National Statistics Sample Death Certificate, United Kingdom. Office of National Statistics.

Centers for Disease Control and Prevention Sample Modified Death Notification Form, USA. Centers for Disease Control and Prevention

Department of Health, South Africa Sample Maternal Death Notification Form, South Africa. South African Department of Health.

Department of Health, South Africa Pattinson, RC. Guidelines for completing the maternal death notification form. 2nd edition. Pretoria: South African Department of Health. 1999.

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