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

This paper examines 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. Maternal mortality ratio prior to the reunification was stable and declined after reunification. This can be attributed to the adoption of a lenient reporting system from West Germany. Unmarried status, on the other hand, became a significant risk factor for maternal mortality after reunification due to changes in support program for pregnant women and mothers, and socioeconomic factors. Elimination of support measures like incentives for check-ups, follow-ups, and guaranteed jobs for single mothers in eastern Germany before the reunification explains the increased maternal mortality rate. In West Germany, unmarried women were associated with low socioeconomic status. Conditions of higher maternal risk and lower socioeconomic status among unmarried mothers from East Germany is now similar to the situation of unmarried mothers in West Germany.