Globally, pregnancy and childbirth remain perilous for hundreds of thousands of women each year, though significant progress has been made in reducing maternal deaths over the past three decades. A new analysis, published in The Lancet, estimates that 2.4 lakh women died from pregnancy-related causes worldwide in 2023. While this figure represents a substantial decline from the 320 deaths per 100,000 live births recorded in 1990, the pace of improvement has slowed, and disparities persist across regions. Understanding these trends in maternal mortality is crucial for prioritizing public health interventions and ensuring safe motherhood for all.
The study, part of the Global Burden of Disease 2023 analysis, examined maternal mortality trends in 204 countries and territories between 1990 and 2023. Researchers define maternal mortality as deaths occurring during pregnancy, childbirth, or within one year after delivery due to causes related to pregnancy. The maternal mortality ratio (MMR)—the number of maternal deaths per 100,000 live births—is the key metric used to track progress. Globally, the MMR in 2023 stood at approximately 190 deaths per 100,000 births, a marked improvement but still far from the levels considered safe by international health organizations.
Uneven Progress and Unmet Global Goals
Despite the overall decline, progress toward the United Nations Sustainable Development Goals (SDGs) is lagging. The SDGs aim to reduce maternal deaths to fewer than 70 deaths per 100,000 live births by 2030. Though, the Lancet study found that more than half of the countries analyzed—104 out of 204—have not yet achieved this target. In many nations, particularly in sub-Saharan Africa, maternal mortality remains alarmingly high, with some regions reporting over 140 deaths per 100,000 births. This highlights the critical need for targeted interventions in areas with the greatest need.
The slowdown in progress since 2015 is particularly concerning. Early gains in the 2000s, driven by increased access to antenatal care, skilled birth attendants, and emergency obstetric services, have stalled or even reversed in several regions. Factors contributing to this stagnation include limited healthcare infrastructure, political instability, and socioeconomic inequalities.
The Impact of COVID-19
The COVID-19 pandemic significantly disrupted maternal healthcare services worldwide, temporarily reversing some of the gains made in reducing maternal mortality. During 2020 and 2021, health systems were overwhelmed, diverting resources away from routine maternal care. Access to antenatal checkups, safe delivery services, and postnatal care was severely limited in many areas. Pregnant women were found to be at increased risk of severe illness from COVID-19, adding to the challenges. Researchers estimate that the pandemic may have resulted in thousands to tens of thousands of additional maternal deaths globally, though precise figures remain difficult to ascertain.
Preventable Causes and Essential Interventions
The vast majority of maternal deaths are preventable, stemming from complications during pregnancy and childbirth. These include severe bleeding after delivery (postpartum hemorrhage), high blood pressure disorders like pre-eclampsia and eclampsia, infections, complications during labor, and unsafe abortions. The World Health Organization emphasizes that timely medical care, skilled birth attendants, access to emergency obstetric services, and comprehensive antenatal and postnatal care are essential for preventing these deaths.
India’s Progress and Remaining Challenges
India has made considerable strides in reducing maternal mortality over the past two decades. According to data from the Sample Registration System (SRS), the MMR has declined from around 556 deaths per 100,000 live births in 1990 to approximately 97 deaths per 100,000 births in recent years. This improvement is largely attributed to increased institutional deliveries, strengthened maternal health programs, and improved access to antenatal care. However, India still faces challenges in reaching the SDG target of below 70 deaths per 100,000 births. Public health experts stress the importance of continued investment in rural healthcare infrastructure, skilled birth attendance, emergency obstetric care, and maternal nutrition to sustain this progress.
The Importance of Accurate Data
The researchers behind the Lancet study underscored the critical need for reliable data on maternal mortality. In many low-income countries, deaths are often underreported or not recorded at all, making it difficult to accurately assess the scale of the problem and design effective interventions. Strengthening health surveillance systems, conducting regular maternal death audits, and improving reporting mechanisms are essential steps toward addressing this data gap. Accurate data allows governments and healthcare organizations to identify areas of greatest need and allocate resources effectively.
Despite the progress made since 1990, maternal mortality remains a significant global public health challenge. For millions of women around the world, particularly those in developing countries, safe pregnancy and childbirth still depend heavily on access to quality healthcare services. Continued investment in maternal health, coupled with a commitment to data-driven decision-making, is essential to ensure that all women have the opportunity to experience a safe and healthy pregnancy and childbirth.
Looking ahead, the focus must remain on strengthening healthcare systems, addressing socioeconomic inequalities, and ensuring access to quality maternal care for all women, regardless of their location or circumstances. The next major assessment of global maternal mortality trends is expected as part of the Global Burden of Disease 2024 analysis, providing further insights into progress and challenges.
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