global maternal mortality fact sheet
Maternal Mortality
- Every day, 1,000 girls and women die in pregnancy or childbirth. In 2008, an estimated 358,000
women died due to complications developed during pregnancy and childbirth.1 For every woman who
dies, at least 20 more suffer injury, infection or disability from maternal causes – approximately seven
million women every year.2 Seventy-five percent of maternal deaths occur during childbirth and the postpartum
period, and the vast majority of maternal deaths and injuries are avoidable when women have
access to health care before, during and after childbirth.3 4
- Maternal deaths are the greatest health inequity of the 21st century.5 Ninety-nine percent of maternal
deaths occur in developing countries. Pregnancy and childbirth are among the leading causes of death
and disability for girls and women in developing countries.6 The chances of a woman dying in pregnancy
or childbirth is one in 14 in Somalia and one in 31 in sub-Saharan Africa, compared with just one in
15,200 in Italy and one in 4,200 in Europe.7 Worldwide, women giving birth in urban areas are twice as
likely to be attended by skilled health workers as those in rural areas.8 Similarly, 84% of women who have
completed secondary or higher education are attended by skilled workers during childbirth.9
- Each year modern contraceptive use prevents 188 million unintended pregnancies resulting in
150,000 fewer maternal deaths.10 If unmet need for family planning were fully satisfied, an additional
90,000 women’s lives would be saved and 590,000 newborn deaths would be averted.11 12 Family
planning and contraception empower women to achieve healthy outcomes for themselves and their
children, advancing greater gender equity and dignity for women and families.
- Combining maternal health needs and family planning would reduce total costs by $1.5 billion.
Investing in both services simultaneously would reduce maternal deaths by more than two-thirds and
dramatically drop the number of unintended pregnancies, newborn deaths and unsafe abortions.13
- Skilled health workers at delivery are key to improving outcomes. Risks of mortality for women and
their babies are highest at the time of birth.14 Only 63% of births in the developing world are attended by
skilled health workers – including midwives as well as doctors and nurses with midwifery skills – up from
53% in 1990.15 The percentage of births attended by skilled health workers remains even lower in
Southern Asia (45%) and sub-Saharan Africa (46%) – the two regions with the greatest number of
maternal deaths.16
- Despite progress in regions where maternal health has been prioritized, only 23 countries are on
target to meet United Nations Millennium Development Goal 5 – to reduce maternal mortality by
75% and achieve universal access to reproductive health services by 2015.17 At the global level,
maternal mortality decreased by less than 2.3% annually since 1990 – far below the 5.5% annual
improvement needed to reach the target.18 19
- Women in the United States have a higher risk of dying from pregnancy-related complications
than women in 40 other countries. Estimated maternal mortality ratios have doubled in the past 20
years, from 6.6 deaths per 100,000 live births in 1987 to 13.3 deaths per 100,000 live births in 2006. Each
year, 1.7 million women suffer serious complications. African American women are nearly four times more
likely to die of pregnancy-related complications than white women.20
Global Impact
- Mothers play a vital role in the economic health of their families and communities. When women
earn income, they reinvest 90% of it into their families while men reinvest only 30-40%.21 Each year, an
estimated $15.5 billion in potential productivity is lost when mothers and newborns die.22 As families
accrue expenses for medical care that they cannot afford and often comes too late, communities take on
the burden of caring for bereaved and impoverished families, and governments are forced to manage the
widespread effects of the cycle of poverty.23
- When girls give birth too young, they miss out on valuable years of education, thereby limiting
their future income and opportunities to escape poverty. Nearly 13 million adolescent girls give birth
each year in developing countries, most often before they are physically, emotionally and financially
prepared.24 A girl growing up in Chad today is more likely to die in childbirth than she is to attend
secondary school.25 When a girl in the developing world receives seven or more years of education, she
marries four years later and has 2.2 fewer children.26 Furthermore, one extra year of primary school or
secondary school increases a girl’s eventual wages by 10-20% or 15-25%, respectively.27
- When a mother dies, her children’s survival is threatened. Infants of mothers who do not survive
delivery are more likely to die within two years.28 Children up to 10 years whose mothers die are three to
10 times more likely to die within two years than children with living mothers.29
- Maternal mortality has long-term implications for a child’s education, care and health. When a
mother dies, enrollment in school for younger children is delayed and older children often leave school to
support their families. Children without a mother are less likely to be immunized and are more likely to
suffer from malnutrition and stunted growth.30 The implications for girls tend to be even greater, leading to
a continued cycle of poverty and poor health.
Proven Interventions
- Low-cost, low-tech interventions provided by skilled birth attendants, combined with family
planning and general health system strengthening, can save most women and newborns. Eighty
percent of maternal deaths could be prevented by cost-effective, timely health care before, during and
after childbirth – including family planning, skilled attendance at birth, emergency medical services and
care in the weeks following birth.31 Fully meeting the need for family planning and maternal and newborn
health services in developing countries would save the lives of 251,000 women and 1.7 million newborns
and prevent 53 million unintended pregnancies and 14.5 million unsafe abortions each year – costing
$24.6 billion annually, a little more than double the current global investment.32
- Increasing the availability of skilled health workers means more women survive childbirth and
more children live through early infancy. A 10% increase in skilled health workers corresponds to a
5% reduction in maternal deaths.33 By increasing the number of midwives, Malaysia, Sri Lanka and
Thailand halved their maternal mortality ratios within 10 years between the 1950s and 1960s, and Egypt
halved its maternal mortality ratio between 1983 and 2000.34 Although the number of women giving birth
with a skilled health worker in attendance has increased in the last decade, the world still needs 4.3
million more health workers.35
U.S. and Global Support
- While U.S. funding for maternal, newborn and child health programs has grown in recent years,
Congress is considering significant cuts to this critical funding. When President Obama took office,
he announced a commitment to investments in maternal and child health through the Global Health
Initiative (GHI). The GHI is committed to reducing maternal mortality by 30% and child mortality by 35%
across assisted countries; doubling the number of at-risk babies born without HIV; and increasing the
contraceptive prevalence rate to 35% across assisted countries.36 However, Congress is debating serious
reductions in spending for foreign assistance, including maternal and child health in FY2011 and FY2012.
MDED will share updates on funding for maternal and child health as they develop.
- The strength of U.S. investment in maternal and newborn health depends on its investments in
family planning. If unmet need for contraceptives were satisfied, declining numbers of unintended
pregnancies would reduce the cost of providing maternal and newborn care by $5.1 billion.37
- With the 2015 deadline to meet Millennium Development Goals 4 and 5 – to reduce child mortality
and improve maternal health – governments and other stakeholders have increased commitments
to maternal, newborn and child health. The G8’s 2010 Muskoka Initiative has garnered over $7 billion
in additional promised funding for disbursement over the next five years – which could assist developing
countries to prevent 64,000 maternal deaths, avert 1.3 million child deaths and provide modern family
planning to 12 million couples between 2010 and 2015.38 The United Nations Secretary-General’s Global
Strategy for Women’s and Children’s Health attracted $40 billion in pledged resources.39 U.S. leadership
in other global health priorities, including HIV and AIDS through the President’s Emergency Plan for AIDS
Relief (PEPFAR), have been critical to increasing access to HIV prevention and treatment and improving
the health of people around the world – and U.S. leadership remains critical to ensuring that political
prioritization in maternal and newborn health is maintained globally.
1 Trends in maternal mortality: 1990 to 2008. Estimates developed by WHO, UNICEF, UNFPA and The World Bank. World Health Organization, Geneva 2010. http://www.who.int/reproductivehealth/publications/monitoring/9789241500265/en/index.html
2 The World Health Report 2005: Make every mother and child count. World Health Organization, Geneva 2005. http://www.who.int/whr/2005/whr2005_en.pdf
3 Ibid.
4 The Millennium Development Goals Report 2007. United Nations, New York 2007. http://www.un.org/millenniumgoals/pdf/mdg2007.pdf
5 Population Issues in the 21st Century: The Role of the World Bank. The World Bank, Washington, DC 2007. http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Resources/281627-1095698140167/PopulationDiscussionPaperApril07Final.pdf
6 World Health Organization Fact sheet N° 334, Geneva 2009. http://www.who.int/mediacentre/factsheets/fs334/en/index.html
7 Trends in maternal mortality, op. cit.
8 The State of the World’s Children 2009, United Nations Children’s Fund, New York 2009. Figure 3.4 Delivery care coverage, p.51. http://www.unicef.org/sowc09/report/report.php
9 The Millennium Development Goals Report 2007, op. cit.
10 World Health Organization (WHO) et al., Trends in Maternal Mortality: 1990 to 2008, Geneva: WHO, 2010.
11 Ibid.
12 Rajaratnam JK et al., Neonatal, postneonatal, childhood, and under-5 mortality in 187 countries, 1970–2010: a systematic analysis of progress towards Millennium Development Goal 4, Lancet, 2010, 375(9730):1988–2008.
13 The Guttmacher Institute and UNFPA. The Costs and Benefits of Investing in Family Planning and Maternal and Newborn Health. December 2009. http://www.guttmacher.org/pubs/AddingItUp2009.pdf
14 The Global Campaign for the Health Millennium Development Goals: First Year Report. World Health Organization, Geneva 2008. http://www.who.int/pmnch/topics/mdgs/20080926norwayprogrep_ghc/en/index.html
15 Trends in maternal mortality, op. cit.
16 The Millennium Development Goals Report 2010. United Nations, New York 2010. http://www.un.org/millenniumgoals/pdf/MDG%20Report%202010%20En%20r15%20-low%20res%2020100615%20-.pdf
17 Hogan M, Foreman K, Naghavi M et al. Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5. The Lancet, 2010, 375(9726): 1609-1623. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60518-1/fulltext
18 Trends in maternal mortality, op. cit.
19 The Millennium Development Goals Report 2008. United Nations, New York 2008, p.25. http://www.undp.org/publications/MDG_Report_2008_En.pdf
20 Deadly Delivery: The Maternal Health Crisis in the USA, op. cit.
21 Phil Borges, Women Empowered: Inspiring Change in the Emerging World. Rizzoli, New York 2007.
22 FY 2002: Program, Performance and Prospects: The Global Health Pillar. US Agency for International Development, Washington, DC 2002. http://www.usaid.gov/pubs/cbj2002/prog_pref2002.html
23 Women Deliver for Development. The Women Deliver Planning Group, Oct 2007. http://www.womendeliver.org/assets/final_program.pdf
24 Pregnant Adolescents: Delivering on Global Promises of Hope. World Health Organization, Geneva 2006. http://www.who.int/child_adolescent_health/documents/9241593784/en/
25 Basic Indicator Statistics. United Nations Children’s Fund, New York 2010. http://www.unicef.org/infobycountry/chad_statistics.html
26 State of World Population.United Nations Population Fund, New York 1990. http://www.who.int/child_adolescent_health/documents/9241593784/en/index.html
27 George Psacharopoulos and Harry Anthony Patrinos. Returns to Investment in Education: A Further Update. Policy Research Working Paper 2881. World Bank, Washington, DC, 2002. http://wwwwds.worldbank.org/external/default/WDSContentServer/IW3P/IB/2002/09/27/000094946_02091705491654/Rendered/PDF/multi0page.pdf
28 FY 2002: Program, Performance and Prospects, op. cit.
29 Sein,T. and Rafai,U.M. No more cradles in the graveyard. Regional Health Forum. World Health Organization Regional Office for South-East Asia, Geneva 2002; 6(2). http://www.searo.who.int/en/Section1243/Section1310/Section1343/Section1344/Section1356_5326.htm
30 Reduction of Maternal Mortality: A Joint WHO/ UNFPA/ UNICEF/World Bank Statement. World Health Organization, Geneva 1999. http://www.who.int/reproductivehealth/publications/monitoring/9789241561952/en/index.htm
31 Beyond the Numbers: Reviewing maternal deaths and complications to make pregnancy safer. World Health Organization, Geneva 2004. http://www.ino.searo.who.int/LinkFiles/Reproductive_health_Beyond_the_numbers.pdf
32 Facts on Investing in Family Planning and Maternal and Newborn Health. The Guttmacher Institute, New York 2010. http://www.guttmacher.org/pubs/FB-AIU-summary.pdf
33 World Health Organization Fact sheet N° 302, 2006. http://www.who.int/mediacentre/factsheets/fs302/en/index.html
35 Skilled Birth Attendants. World Health Organization. http://www.who.int/making_pregnancy_safer/topics/skilled_birth/en/index.html
36 The State of the World’s Children 2009, op. cit.
37 Every Woman Every Child. United Nations, 2010. http://www.everywomaneverychild.org/
38 Facts on Investing in Family Planning and Maternal and Newborn Health, op. cit.
39 Muskoka Declaration: Recovery and New Beginnings. G8, Muskoka 2010. http://www.g8.utoronto.ca/summit/2010muskoka/communique.html
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