I vividly recall when I was a medical student, the Ministry of Health was campaigning hard to reduce home delivery. It recruited ‘bidan kampung’ or village midwife to work with trained community nurse and midwife to promote hospital childbirth. For the next few years, we saw a gradual decline in maternal mortality due to excessive childbirth bleeding (postpartum hemorrhage). There were occasional cases of mothers dying from deep jungles, especially orang asli commune or those from interior parts of East Malaysia.
The reason for a higher mortality is due to the difficulty to reach the hospital. The postpartum bleeding can be excessive and mothers deteriorate very fast. The other causes include obstructed labor and sepsis.