Objective: To determine the risk of maternal mortality and serious maternal morbidity because of major obstetric haemorrhage in Jehovah's witnesses in The Netherlands.
Design: A retrospective study of case notes.
Setting: All tertiary care centres, general teaching hospitals and other general hospitals in The Netherlands.
Sample: All cases of maternal mortality in The Netherlands between 1983 and 2006 and all cases of serious maternal morbidity in The Netherlands between 2004 and 2006.
Methods: Study of case notes using two different nationwide enquiries over two different time periods.
Main outcome measures: Maternal mortality ratio (MMR) and risk of serious maternal mortality.
Results: The MMR for Jehovah's witnesses was 68 per 100,000 live births. We found a risk of 14 per 1000 for Jehovah's witnesses to experience serious maternal morbidity because of obstetric haemorrhage while the risk for the total pregnant population was 4.5 per 1000.
Conclusions: Women who are Jehovah's witnesses are at a six times increased risk for maternal death, at a 130 times increased risk for maternal death because of major obstetric haemorrhage and at a 3.1 times increased risk for serious maternal morbidity because of obstetric haemorrhage, compared to the general Dutch population.