Publication Title: Social Science & Medicine

Pages:1749-56

Abstract: Averting women’s pregnancy-related death is today recognized as an international health and development priority. Maternal survival is, in this sense, a success story. There is, however, little research into what happens to the women who survive the severe obstetric complications that are the main causes of maternal mortality. This paper examines findings from repeated in-depth interviews with 64 women who survived a clinically defined “near-miss.”These interviews were conducted as part of a prospective longitudinal study of women who “nearly died” of pregnancy-related complications in Burkina Faso, a poor country in West Africa. Drawing on sociological and anthropological perspectives that consider the defining characteristics of “loss” to be social as much as biomedical, the paper seeks to understand loss as disruption of familiar forms and patterns of life. Women’s accounts of their lives in the year following the near-miss event show that such events are not only about blood loss, seizures or infections, but also about a household crisis for which all available resources were mobilized, with a train of physical, economic, and social consequences. The paper argues that near-miss events are characterised by the near-loss of a woman’s life, but also frequently by the loss of the baby and by further significant disruptions in three overlapping dimensions of women’s lives. Maternal health policy needs to be concerned not only with averting the loss of life, but also with preventing or ameliorating others losses set in motion by an obstetric crisis.