Eighty years ago around one woman in 200 giving birth in the West died, mainly from post-partum sepsis as well as from hemorrhage and hypertensive disease. With the advent of sulphonamides and antibiotics, the maternal death rate plummeted. From the 1940s the introduction of organized pre-natal care, methods to predict which patients were moderate or high risk, procedures for appropriate interventions, and effective reduction of post-partum bleeding resulted in a steady decrease in maternal mortality. Maternal deaths in the West are currently so rare that standards of care are assessed by reference to the perinatal mortality rate.
However the incidence of one potentially life-threatening obstetric condition is seriously increasing, namely Placenta accreta, when either part or all of the placenta invades the uterus wall and becomes inseparable from it, even involving adjacent organs in some cases. The placenta cannot be delivered normally, causing massive hemorrhage even when a hysterectomy is performed to control bleeding. In the 1950s Placenta accreta occurred in one in 30,000 Western pregnancies