Maternal death
Maternal death refers to the death of a woman during pregnancy, childbirth, or within 42 days after the end of a pregnancy, primarily due to complications related to these processes. The maternal mortality rate (MMR) is a critical indicator of a nation's healthcare system and socioeconomic conditions, with higher rates often observed in developing countries where healthcare access and resources may be limited. Leading causes of maternal death globally include infection, hemorrhage, high blood pressure, and complications from unsafe abortions. Regions such as sub-Saharan Africa and Southern Asia account for a significant proportion of these deaths, exacerbated by factors like poverty and insufficient prenatal care.
Efforts to reduce maternal mortality have shown progress, particularly through international initiatives like the UN's Millennium and Sustainable Development Goals. However, disparities persist, even among developed nations, where factors such as race, socioeconomic status, and healthcare access can significantly influence maternal health outcomes. Recent data indicate that in the United States, maternal death rates have been increasing, particularly impacting marginalized communities. Addressing maternal death requires a multifaceted approach, including improved healthcare access, education, and nutrition, particularly in regions with high maternal mortality.
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Maternal death
Maternal death rates are determined by calculating the number of deaths per 100,000 live births that occur as a result of complications during pregnancy or childbirth or that occur within forty-two days of the end of a pregnancy. Maternal death rates are a major factor in understanding the overall health of a nation. Thus, rates are particularly high in developing nations where poverty is high and healthcare expenditure is poor. The World Health Organization (WHO) reports that the leading causes of maternal death are infection, hemorrhage, high blood pressure, and delivery complications. About two-thirds of those deaths occur in sub-Saharan Africa, and close to one-fifth take place in Southern Asia. Lower-income nations as a whole account for 94 percent of the world’s total maternal deaths. In response to international efforts outlined in the United Nations (UN) Millennium Development Goals that called for reducing the global maternal death rate by three-fourths by 2015, maternal death rates have been declining since the 1990s. Between 2000 and 2020, the maternal mortality ratio (MMR) experienced a worldwide decrease of 34 percent, according to the WHO. To further reduce maternal mortality, a new target was proposed in 2015 in the UN Sustainable Development Goals, which called for “reducing the global MMR to less than 70 per 100,000 births, with no country having a maternal mortality rate of more than twice the global average” by 2030.
Overview
In developed nations, maternal deaths are most often caused by complications during delivery or by conditions that occur during pregnancy, such as placental disruptions or multiple gestations. In developing nations, maternal deaths may also result from infectious diseases such as malaria and HIV/AIDS. In 2014, for instance, it was estimated that 7,500 maternal deaths were the result of HIV/AIDS, with 91 percent of those deaths occurring in sub-Saharan Africa.
Hemorrhage is the direct cause of death in more than a third of maternal deaths in sub-Saharan Africa and in almost a third of deaths in Asia. Hemorrhage is more likely to occur among people over the age of forty or under the age of twenty. Mothers or birthing parents in both age groups are less likely to receive prenatal care, and older people are more likely than younger people to give birth outside the presence of a skilled attendant. In Latin America and the Caribbean, more than a fourth of all deaths result from complications caused by pregnancy-related hypertension. Another leading cause of maternal death is unsafe abortions, which is responsible for 13 percent of all maternal deaths globally.
In the 1980s, the WHO estimated that half a million maternal deaths occurred each year. At the Safe Motherhood Conference in Nairobi in 1987, global attention was focused on the subject for the first time. As a result of concentrated efforts, between 1990 and 2015, maternal death rates declined by 44 percent in both developed and developing nations. The decrease in maternal deaths was most significant in East Asia during the same period, where deaths decreased by 72 percent.
Within the categories of “developed” and “developing” (also often referred to as "low-income" and "high-income" nations), there are considerable variations in maternal death rates. European nations tend to have the lowest maternal death rates. The United States, by contrast, had a maternal death rate of nineteen in 2019. While the US maternal death rate declined significantly between 1935 and 2007, since then a rise in the US maternal death rate has resulted from differences in cause of death classification methods and an increase in the number of Cesarean births. The leading causes of maternal deaths in the United States are pregnancy-induced hypertension, embolisms, infections, and chronic health conditions such as diabetes, as well as obesity-related complications. The rate is affected by such factors as race, ethnicity, socioeconomic status, and geography according to a 2010 report by Gopalk Singh for the Health Resources and Services Administration.
Maternal death rates in the US and other parts of the world were also impacted by the COVID-19 pandemic that began in early 2020. In the US, for instance, maternal mortality rates climbed from 20 deaths per 100,000 births in 2019 to 24 deaths per 100,000 births in 2020. Moreover, Black people were disproportionately affected, with rates reaching 55 deaths per 100,000 births in 2020 among Black mothers or birthing parents, according to the National Center for Health Statistics. These rates continued to rise during the 2020s. In 2021, deaths of pregnant women soared by 40 percent in the United States, according to the Centers for Disease Control and Prevention (CDC), bringing the US maternal death rate to 32.9 deaths per 100,000 births in 2021. That rate was far higher than many other high-income countries, which tended to have rates around 2 deaths per 100,000 births. Experts attributed this increase to continued challenges related to the COVID-19 pandemic as well as abortion restrictions and staffing shortages in hospitals.
Malnutrition is a leading cause of maternal death in the developing world, and one in five maternal deaths occurs as a result of anemia. In Africa, where maternal malnutrition rates are high, international efforts have concentrated on programs designed to improve nutrition during pregnancy and lactation, reducing incidences of infections such as malaria and hookworm that contribute to malnutrition, and encouraging family planning so that women do not give birth more than once within a three-year period.
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