Childbirth Death Risk High in Jehovah's Witnesses

Thursday November 8 5:32 PM ET

By Charnicia E. Huggins

NEW YORK (Reuters Health) -Women who are Jehovah's Witnesses have a dramatically increased risk of death due to excessive blood loss during childbirth and their refusal to replenish this loss with donated blood, according to the results of a study.

Blood transfusions are the conventional treatment for obstetric hemorrhage, or excessive blood loss, but such procedures, along with any other medical treatments that involve the administration of blood or blood products, are forbidden by the Jehovah's Witness religion.

"Pregnancy is safe for women who accept blood products,'' lead study author Dr. Carl J. Saphier of Mount Sinai School of Medicine in New York told Reuters Health.

Those who reject such products, on the other hand, may have an increased risk of mortality, "but it may be minimized by giving appropriate care,'' he said.

Saphier and his colleagues investigated the risk of maternal death in a study of 332 Jehovah's Witnesses who gave birth at Mount Sinai Medical Center from January 1988 through December 1999.

Nearly 400 deliveries--both vaginal and Cesarean--took place during the study period, and 24 patients (6%) experienced an obstetric hemorrhage, Saphier and his colleagues report in the October issue of the American Journal of Obstetrics and Gynecology (news - web sites).

Two women died from the hemorrhage, corresponding to a rate of 521 deaths per 100,000 live births--a maternal death rate nearly 44 times higher than that among the general US population, the report indicates.

Currently, treating obstetric hemorrhage and certain other conditions among Jehovah's Witnesses may involve the use of blood-free products called volume expanders--solutions that are mixed with the patient's own blood to make up for blood lost during surgery--or cell savers, which are devices that collect and recycle the patient's blood.

For one of the patients who died, however, the cell saver treatment was ineffective because she had already lost large amounts of blood vaginally, the authors note.

"The findings imply that special care is required for women who are Jehovah's Witnesses, including special counseling prior to delivery, methods of minimizing the blood loss at delivery, and fast treatment for any hemorrhage,'' Saphier said.

SOURCE: American Journal of Obstetrics and Gynecology
2001;185:893-895.