Overall and abortion-related maternal mortality rates in Uruguay over the past 25 years and their association with policies and actions aimed at protecting women's rights

Objective: To evaluate changes in maternal mortality rates in Uruguay over the past 25 years, as well as their distribution by cause, and their temporal relationship with social changes and Human Development Index (HDI) indicators. Methods: Data on maternal mortality obtained directly from the Uruguayan Ministry of Public Health for the 2001 to 2015 period were analyzed together with data from the United Nations Inter-Agency Group for Child Mortality Estimation for the 1990 to 2015 period. The swiftness of the decrease in maternal mortality per five-year period, the variation in the percentage of abortion-related deaths, and the correlation with HDI indicators were evaluated. Results: Maternal mortality decreased significantly, basically due to a reduction in the number of deaths from unsafe abortion, which was the principal cause of maternal mortality in the 1990s. The reduction in maternal mortality over the past 10 years also coincides with a reduction in poverty and an improvement in the HDI. Conclusion: A rapid reduction occurred in maternal mortality in Uruguay, particularly in maternal mortality resulting from unsafe abortion. This coincided with the application of a model for reducing the risk and harm of unsafe abortions, which finally led to the decriminalization of abortion. (C) 2016 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics.