Maternal mortality in the former East Germany before and after reunification: changes in risk by marital status

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Abstract
Maternal mortality is a sensitive indicator of social inequalities and is closely linked to socioeconomic and marital status. In the former West Germany the risk of maternal death is 1.8 times higher in unmarried women than in married women,1 and being unmarried is closely associated with lower socioeconomic status.2 German reunification, which took place in 1990, was accompanied by major social and societal changes in the former East Germany. Overall fertility declined by 60% between 1989 and 1994, but the proportion of births to unmarried women rose progressively from 23% in 1980 to 42% in 1996. We examined the impact of marital status on maternal mortality in the period before and the period after German reunification in the area covered by the former East Germany (referred to in this article as eastern Germany). We calculated the maternal mortality ratio by relating the number of …

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