Maternal mortality (2023)


Maternal mortality is unacceptably high. About 287 000 women died during and following pregnancy and childbirth in 2020. Almost 95% of all maternal deaths occurred in low and lower middle-income countries in 2020, and most could have been prevented.

Sustainable Development Goal (SDG) regions and sub-regions are used here. Sub-Saharan Africa and Southern Asia accounted for around 87% (253 000) of the estimated global maternal deaths in 2020. Sub-Saharan Africa alone accounted for around 70% of maternal deaths (202 000), while Southern Asia accounted for around 16% (47 000).

At the same time, between 2000 and 2020, Eastern Europe and Southern Asia achieved the greatest overall reduction in maternal mortality ratio (MMR): a decline of 70% (from an MMR of 38 to 11) and 67% (from an MMR of 408 down to 134), respectively. Despite its very high MMR in 2020, Sub-Saharan Africa also achieved a substantial reduction in MMR of 33% between 2000 and 2020. Four SDG sub-regions roughly halved their MMRs during this period: Eastern Africa, Central Asia, Eastern Asia, and Northern Africa and Western Europe reduced their MMR by around one third. Overall, the maternal mortality ratio (MMR) in least-developed countries* declined by just under 50%. In land locked developing countries the MMR decreased by 50% (from 729 to 368). In small island developing countries the MMR declined by 19% (from 254 to 206).

* For details of countries considered in the group of “least developed” please refer to standard country or area codes for statistical use (M49) available at:

Where do maternal deaths occur?

The high number of maternal deaths in some areas of the world reflects inequalities in access to quality health services and highlights the gap between rich and poor. The MMR in low-income countries in 2020 was 430 per 100 000 live births versus 12 per 100 000 live births in high income countries.

Humanitarian, conflict, and post-conflict settings hinder progress in reducing the burden of maternal mortality. In 2020, according to the Fragile States Index (1), 9 countries were “very high alert” or “high alert” (from highest to lowest: Yemen, Somalia, South Sudan, the Syrian Arab Republic, the Democratic Republic of the Congo, the Central African Republic, Chad, Sudan and Afghanistan); these countries had MMRs ranging from 30 (the Syrian Arab Republic) to 1223 (South Sudan) in 2020. The average MMR for very high and high alert fragile states in 2020 was 551 per 100 000, over double the world average.

(Video) What’s behind America’s rising maternal mortality rate

Women in low-income countries have a higher lifetime risk of death of maternal death. A woman’s lifetime risk of maternal death is the probability that a 15-year-old woman will eventually die from a maternal cause. In high income countries, this is 1 in 5300, versus 1 in 49 in low-income countries.

Why do women die?

Women die as a result of complications during and following pregnancy and childbirth. Most of these complications develop during pregnancy and most are preventable or treatable. Other complications may exist before pregnancy but are worsened during pregnancy, especially if not managed as part of the woman’s care. The major complications that account for nearly 75% of all maternal deaths are (2):

  • severe bleeding (mostly bleeding after childbirth);
  • infections (usually after childbirth);
  • high blood pressure during pregnancy (pre-eclampsia and eclampsia);
  • complications from delivery; and
  • unsafe abortion.

How can women’s lives be saved?

To avoid maternal deaths, it is vital to prevent unintended pregnancies. All women, including adolescents, need access to contraception, safe abortion services to the full extent of the law, and quality post-abortion care.

Most maternal deaths are preventable, as the health-care solutions to prevent or manage complications are well known. All women need access to high quality care in pregnancy, and during and after childbirth. Maternal health and newborn health are closely linked. It is particularly important that all births are attended by skilled health professionals, as timely management and treatment can make the difference between life and death for the women as well as for the newborn.

Severe bleeding after birth can kill a healthy woman within hours if she is unattended. Injecting oxytocics immediately after childbirth effectively reduces the risk of bleeding.

Infection after childbirth can be eliminated if good hygiene is practiced and if early signs of infection are recognized and treated in a timely manner.

(Video) Black maternal mortality in US and its slave origins

Pre-eclampsia should be detected and appropriately managed before the onset of convulsions (eclampsia) and other life-threatening complications. Administering drugs such as magnesium sulfate for pre-eclampsia can lower a woman’s risk of developing eclampsia.

Why do women not get the care they need?

Poor women in remote areas are the least likely to receive adequate health care (3). This is especially true for SDG regions with relatively low numbers of skilled health care providers, such as Sub-Saharan Africa and Southern Asia.

The latest available data suggest that in most high income and upper middle income countries, approximately 99% of all births benefit from the presence of a trained midwife, doctor or nurse. However, only 68% in low income and 78% in lower-middle-income countries are assisted by such skilled health personnel (4).

Factors that prevent women from receiving or seeking care during pregnancy and childbirth are:

  • health system failures that translate to (i) poor quality of care, including disrespect, mistreatment and abuse, (ii); insufficient numbers of and inadequately trained health workers, (iii); shortages of essential medical supplies; and (iv) the poor accountability of health systems;.
  • social determinants, including income, access to education, race and ethnicity, that put some sub-populations at greater risk;
  • harmful gender norms and/or inequalities that result in a low prioritization of the rights of women and girls, including their right to safe, quality and affordable sexual and reproductive health services; and
  • external factors contributing to instability and health system fragility, such as climate and humanitarian crises.

To improve maternal health, barriers that limit access to quality maternal health services must be identified and addressed at both health system and societal levels.

What was the impact of COVID-19 pandemic on maternal mortality?

It is clear from the data that the stagnation in maternal mortality reductions pre-dates the start of the COVID-19 pandemic in 2020. The COVID-19 pandemic may have contributed to the lack of progress but does not represent the full explanation.

(Video) Maternal Mortality

The level of maternal mortality during the COVID-19 pandemic may have been impacted by two mechanisms: deaths where the woman died due to the interaction between her pregnant state and COVID-19 (known as an indirect obstetric deaths), or deaths where pregnancy complications were not prevented or managed due to disruption of health services.

A robust global assessment of the impact of COVID-19 on maternal mortality is not possible from the data currently available: only around 20% of the countries and territories have thus far reported empirical data on their maternal mortality levels in 2020, and high-income and/or relatively smaller populations are over-represented in this group – with implications for generalizability of findings.

The current estimates only extend to include the year 2020. Given the limited data, we expect these estimates to be revised in future updates.

The Sustainable Development Goals and maternal mortality

In the context of the Sustainable Development Goals (SDG), countries have united behind the target to accelerate the decline of maternal mortality by 2030. SDG 3 includes an ambitious target: “reducing the global MMR to less than 70 per 100000 births, with no country having a maternal mortality rate of more than twice the global average”.

The global MMR in 2020 was 223 per 100 000 live births; achieving a global MMR below 70 by the year 2030 will require an annual rate of reduction of 11.6%, a rate that has rarely been achieved at the national level. However, scientific and medical knowledge are available to prevent most maternal deaths. With 10 years of SDGs remaining, now is the time to intensify coordinated efforts, and to mobilize and reinvigorate global, regional, national, and community-level commitments to end preventable maternal mortality.

WHO response

Improving maternal health is one of WHO’s key priorities. WHO works to contribute to the reduction of maternal mortality by increasing research evidence, providing evidence-based clinical and programmatic guidance, setting global standards, and providing technical support to Member States on developing and implementing effective policy and programmes.

(Video) ObGyn Discusses Maternal Mortality

As defined in the Strategies toward ending preventable maternal mortality (EPMM) and Ending preventable maternal mortality: a renewed focus for improving maternal and newborn health and well-being, WHO is working with partners in supporting countries towards:

  • addressing inequalities in access to and quality of reproductive, maternal and newborn health care services;
  • ensuring universal health coverage for comprehensive reproductive, maternal and newborn health care;
  • addressing all causes of maternal mortality, reproductive and maternal morbidities, and related disabilities;
  • strengthening health systems to collect high quality data in order to respond to the needs and priorities of women and girls; and
  • ensuring accountability in order to improve quality of care and equity.


1. Fragile States Index. Available at:

2. Say L, Chou D, Gemmill A et al. Global Causes of Maternal Death: A WHO Systematic Analysis. Lancet Global Health. 2014;2(6): e323-e333.

3. Samuel O, Zewotir T, North D. Decomposing the urban–rural inequalities in the utilisation of maternal health care services: evidence from 27 selected countries in sub-Saharan Africa. Reprod Health 18, 216 (2021).

4. World Health Organization and United Nations Children’s Fund. WHO/UNICEF joint database on SDG 3.1.2 Skilled Attendance at Birth. Available at:

(Video) Human rights: Maternal mortality and morbidity


What are the top 4 causes of maternal mortality? ›

infections (usually after childbirth); high blood pressure during pregnancy (pre-eclampsia and eclampsia); complications from delivery; and. unsafe abortion.

How do you solve maternal mortality? ›

What Is in State Strategies for Preventing Pregnancy-Related Deaths?
  1. Eliminate racial and ethnic disparities in maternal mortality.
  2. Invest in and partner with communities.
  3. Ensure access to care for all pregnant and postpartum persons.
  4. Ensure quality care for all pregnant and postpartum persons.
Jun 15, 2022

What is the number one cause of maternal mortality? ›

During pregnancy, hemorrhage and cardiovascular conditions are the leading causes of death. At birth and shortly after, infection is the leading cause.

What is the meaning of maternal mortality? ›

Definition: The annual number of female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy.

Why is maternal mortality so high in the US? ›

A high rate of cesarean sections, inadequate prenatal care, and elevated rates of chronic illnesses like obesity, diabetes, and heart disease may be factors contributing to the high U.S. maternal mortality rate.

What is the most common cause of maternal mortality in US? ›

Cardiovascular disorders are the leading cause of maternal mortality in the US, and Black women have higher rates of pregnancy-related heart attack, stroke, peripartum cardiomyopathy, and pulmonary embolism than White women, even when differences in age, health conditions, cesarean section rate, socioeconomic factors, ...

What are the five major causes of maternal mortality? ›

The most common direct causes of maternal injury and death are excessive blood loss, infection, high blood pressure, unsafe abortion, and obstructed labour, as well as indirect causes such as anemia, malaria, and heart disease.

How can the government reduce maternal mortality? ›

strengthen policy and political support for maternal health; • apply a rights perspective to strengthening health systems; • increase women's entitlement and access; • increase state accountability for maternal health; and • integrate a rights perspective into aid instruments.

Why do we need to reduce maternal mortality? ›

Reducing maternal deaths and improving maternal health provide many benefits, including: Improving labor supply and productive capacity in women of reproductive age, resulting in improved household income and economic well-being of families and communities.

What are the top 3 causes of maternal deaths? ›

Heart disease and stroke cause most deaths overall. Obstetric emergencies, like severe bleeding and amniotic fluid embolism (when amniotic fluid enters a mother's bloodstream), cause most deaths at delivery. In the week after delivery, severe bleeding, high blood pressure and infection are most common.

What are the three delays in maternal mortality? ›

The "Three Delays" model proposes that pregnancy-related mortality is overwhelmingly due to delays in: (1) deciding to seek appropriate medical help for an obstetric emergency; (2) reaching an appropriate obstetric facility; and (3) receiving adequate care when a facility is reached.

Why is maternal mortality difficult? ›

Maternal mortality is difficult to measure. Vital registration and health information systems in most developing countries are weak, and thus, cannot provide an accurate assessment of maternal mortality.

What is maternal mortality and its causes? ›

The major complications that account for nearly two-thirds of all maternal deaths are severe bleeding (mostly bleeding after childbirth), infections (usually after childbirth), high blood pressure during pregnancy (pre-eclampsia and eclampsia), complications from delivery and unsafe abortions.

What are the effects of maternal mortality? ›

Potential EffectsOn Children
EconomicIncreased labor force participation
HealthIllness Injury Malnutrition Poor hygiene
PsychologicalDepression Other psychological problems
SocialSocial isolation Reduced education Reduced parental supervision and care
1 more row

What are the types of maternal mortality? ›

Maternal deaths are subdivided into two groups, direct and indirect obstetric deaths. *This includes delivery, ectopic pregnancy, miscarriage or termination. Complications of pregnancy or childbirth can lead to death beyond the 6 weeks' postpartum period and are classified as a late maternal death.

Who has the worst maternal mortality rate? ›

The U.S. maternal mortality rate is exceptionally high for Black women. It is more than double the average rate and nearly three times higher than the rate for white women.

What country has the lowest maternal mortality rate? ›

The countries that achieved the lowest maternal mortality ratio are Finland, Greece, Iceland, and Poland. For every 100,000 births, 3 mothers die.

Which state in US has highest maternal mortality rate? ›

Louisiana, on the other hand, has a shocking 58.1 maternal deaths per 100,000 births, the highest in America.

What is the fear of dying in childbirth? ›

Women still suffer from the fear of death during delivery. When this specific anxiety or fear of death during parturition precedes pregnancy and is so intense that tokos (childbirth) is avoided whenever possible, this is a phobic state called “tokophobia”. Tokophobia may effect women from childhood into old age.

What percentage of maternal mortality is preventable? ›

Most pregnancy-related deaths of AI/AN people (93%) were determined to be preventable. About 64% of deaths occurred between 7 days to 1 year after pregnancy. More than half (53%) of pregnancy-related deaths happen up to one year after delivery.

Why is maternal mortality so important? ›

Maternal mortality is often used as an international indicator of the health of a population overall. From 1990 to 2013, research published in medical journal The Lancet found that on average, developed countries saw a 3.1% annual decline in an assessment of maternal mortality ratio.

Why is it important to improve maternal health? ›

Improving maternal health is key to saving the lives of more than half a million women who die as a result of complications from pregnancy and childbirth each year.

What is the difference between maternal death and maternal mortality? ›

Maternal morbidity describes any short- or long-term health problems that result from being pregnant and giving birth. Maternal mortality refers to the death of a woman from complications of pregnancy or childbirth that occur during the pregnancy or within 6 weeks after the pregnancy ends.

Does age affect maternal mortality? ›

Rates increased with maternal age. Rates in 2020 were 13.8 deaths per 100,000 live births for women under age 25, 22.8 for those aged 25–39, and 107.9 for those aged 40 and over (Figure 2 and Table).

What are the major causes of mortality? ›

Leading Causes of Death
  • Heart disease: 695,547.
  • Cancer: 605,213.
  • COVID-19: 416,893.
  • Accidents (unintentional injuries): 224,935.
  • Stroke (cerebrovascular diseases): 162,890.
  • Chronic lower respiratory diseases: 142,342.
  • Alzheimer's disease: 119,399.
  • Diabetes: 103,294.

What are the 5 major causes of maternal mortality? ›

The most common direct causes of maternal injury and death are excessive blood loss, infection, high blood pressure, unsafe abortion, and obstructed labour, as well as indirect causes such as anemia, malaria, and heart disease.

What are the top 5 leading causes of mortality? ›

Leading Causes of Death
  • Heart disease: 695,547.
  • Cancer: 605,213.
  • COVID-19: 416,893.
  • Accidents (unintentional injuries): 224,935.
  • Stroke (cerebrovascular diseases): 162,890.
  • Chronic lower respiratory diseases: 142,342.
  • Alzheimer's disease: 119,399.
  • Diabetes: 103,294.

What are the drivers of maternal mortality? ›

In the first week postpartum, severe bleeding, high blood pressure, and infection are the most common contributors to maternal deaths, while cardiomyopathy is the leading cause of late deaths.


1. U.S. Maternal Mortality is Much Higher for African-Americans
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2. Preventing Maternal Mortality and Morbidity - PowerPoint Presentation
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4. The fight to end Texas' high maternal mortality rate
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