Low-income countries have the highest death rates from pregnancy complications.


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In 2020, 800 women worldwide died each day from causes related to pregnancy and childbirth-approximately one death every two minutes. Almost 95% of these deaths occurred in low-income and lower-middle-income countries, and most were preventable, according to the World Health Organization (WHO).


While still grim, these numbers reflect improvement in global maternal health. They are one-third lower than deaths tallied from 2000 to 2015. But progress stalled between 2016 and 2020, the WHO and its partners warned in a recent report, and maternal mortality rates are actually rising in Latin America, the Caribbean, Europe, and North America.


Based on data from 185 countries and territories, the WHO report documents inequities in maternal survival among global regions and countries. For example, the lifetime risk of maternal death for a 15-year-old girl in sub-Saharan Africa (where 70% of maternal deaths occurred in 2020) is one in 40 compared to one in 16,000 in Australia and New Zealand, countries with among the lowest maternal mortality rates. If progress in improving care for pregnant women doesn't pick up, the WHO predicts that the global maternal mortality rate will be 222 maternal deaths per 100,000 live births-more than three times the United Nations' sustainable development goal of 70 by 2030.


The main causes of maternal deaths are severe bleeding (mostly after childbirth), infection, high blood pressure during pregnancy, complications from delivery, and unsafe abortion, according to the WHO. Available technology and clinical skill can prevent most of these deaths. However, such resources are scarce in many poor countries. Other contributing factors to maternal mortality include income and education inequality and gender and race biases. War, natural disaster, and other humanitarian crises compound these problems.


Among high-income nations, the United States has the highest maternal mortality rate-rising from 12 deaths per 100,000 live births in 2000 to 21 deaths per 100,000 live births in 2020. The WHO report calls for collective action to reinvigorate progress toward reducing global maternal mortality. Among the recommendations are achieving universal health coverage, strengthening health care system resilience to climate and humanitarian crises, providing more skilled health care professionals, and empowering women by reducing poverty and gender-based inequality. Women also need access to contraception, safe abortion services, and quality postabortion care. Unless these measures are taken, the WHO predicts that the goal of preventing maternal deaths worldwide by 2030 will miss the mark by 1 million lives. Read the full report at http://www.who.int/publications/i/item/9789240068759.-Gail M. Pfeifer, MA, RN