Maternal mortality is a major public health concern worldwide, as every woman has the right to a safe pregnancy and childbirth.

Despite significant progress in reducing global maternal mortality rates in the past few decades, still about 295,000 women died in pregnancy or childbirth in 2017, according to a WHO report. That’s a woman losing her life every 120 seconds. The vast majority of these deaths occur in low-income and middle-income countries, especially in sub-Saharan Africa and South Asia, and are entirely preventable.

Here’s a closer look at maternal mortality and its causes.

What is maternal mortality?

Maternal mortality refers to the death of a woman while pregnant, during childbirth, or within 42 days after the end of pregnancy.

This includes deaths from any cause related to or aggravated by pregnancy or its management, but not from accidental or incidental causes. The WHO estimates that 99% of all maternal deaths occur in developing countries. Maternal mortality is a widely used indicator of the status of women’s health and the quality of healthcare services.

What are the causes of maternal mortality?

The causes of maternal mortality are multiple and complex, and often interlinked with poverty, gender inequality, lack of education, and inadequate access to healthcare. Some of the common direct causes of maternal death include:.

Severe bleeding (postpartum hemorrhage)
Infections (sepsis, tetanus, malaria, HIV)
High blood pressure and its complications (eclampsia and pre-eclampsia)
Obstructed labor (when the baby cannot pass through the birth canal)
Unsafe abortion

Indirect causes of maternal mortality include pre-existing medical conditions, such as HIV, diabetes, hypertension, or heart disease, which can be worsened by pregnancy.

Poor nutrition, anemia, and mental health problems also contribute to maternal death.

Who is at risk of maternal mortality?

Maternal mortality affects women of all ages and social backgrounds, but the risks are higher among adolescent girls and women over 35 years old, as well as those living in poverty, rural areas, conflict zones, and with limited access to healthcare.

Women with restricted access to family planning and reproductive health services are also at a higher risk of dying from unsafe abortion or pregnancy-related complications. Additionally, women with pre-existing medical conditions, such as HIV, diabetes, hypertension, or heart disease, are more vulnerable to maternal death.

What can be done to prevent maternal mortality?

Preventing maternal mortality requires a multifaceted approach that addresses the underlying social, economic, and political determinants of health, as well as improving the quality and coverage of maternal health services.

Some of the proven interventions to reduce maternal mortality include:.

Ensuring universal access to quality reproductive health services, including family planning, antenatal care, skilled attendance at delivery, emergency obstetric care, and postpartum care.
Training and supporting midwives and other skilled birth attendants in delivering quality, respectful, and culturally sensitive care to women and newborns.
Empowering women and promoting gender equality by improving their education, economic opportunities, and decision making, and by addressing harmful social norms and attitudes that discriminate against women.
Strengthening health systems by investing in infrastructure, equipment, supplies, and drugs, as well as information systems, monitoring, and evaluation.
Reducing poverty and improving social protection by increasing access to basic services, such as water, sanitation, and nutrition, and by implementing policies that support vulnerable populations, including pregnant and lactating women.

The Sustainable Development Goals (SDGs) adopted by the United Nations in 2015 include several targets related to maternal mortality and maternal health, as part of the overall goal of ensuring healthy lives and promoting well-being for all:.

SDG 3: Ensure healthy lives and promote well-being for all at all ages
Target 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
Target 3.2: By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births
Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes
Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences

Conclusion

Maternal mortality is a preventable tragedy that affects millions of women and families worldwide. Every woman has the right to a safe, respectful, and dignified pregnancy and childbirth, regardless of her social or economic status.

Reducing maternal mortality requires collective and sustained efforts from governments, health professionals, civil society, and communities, to address the root causes of inequality and injustice, and to invest in the health and well-being of women and their children.