Social Differences in Maternal Mortality in Zeeland 1812–1913

Using population reconstructions from linked civil certificates for the province of Zeeland, the Netherlands, for the period 1812–1913, I study the social gradient in maternal mortality. Maternal mortality is defined as deaths in the first 42 days after the birth of a child. Among the women — mother to at least one child and followed between age 20 and 45 — maternal mortality constitutes about one third of the total number of observed deaths. Maternal mortality is higher for upper class women in early 19th century Zeeland than for unskilled laborers. By the early 20th century, maternal mortality had become an uncommon event and social differences in its likelihood negligible. A comparison of the social gradient in maternal mortality to the social gradient in all mortality in the reproductive ages (age 20-45) in this period shows that the reverse social gradient in mortality is limited to maternal mortality — it is not found for all women's deaths in this period of life.