Every day, 800 women die from pregnancy-related causes during pregnancy, childbirth and postpartum. Over 99% of these 289,000 annual deaths occur in developing countries, and most are avoidable, as the health-care solutions to prevent or manage complications are well known. About 62% of the deaths occurred in Sub-Saharan Africa with another 24% in South Asia – these two regions together account for 85% of maternal mortality in the world.
What proportion mothers die? Understanding the MMR
The Maternal Mortality Ratio (MMR) is defined as the number of maternal deaths during a given time period per 100,000 live births during the same time-period. It indicates the quality of the healthcare system.
As you can see in the chart below, Sub-Saharan Africa had the highest MMR at 510 per 100,000 births in 2013, followed by South Asia – 190 per 100,000. Other regions had significantly lower MMR.
The probability of dying from maternal causes
The adult lifetime risk of maternal deaths (the probability that a 15-year-old female will eventually die due to a maternal cause) shows extreme contrast across countries due to high risk per birth and high fertility in developing countries.
In Chad, 1 in 15 women will die of maternal causes, in Somalia it’s 1 in 18, in Niger 20, in Sierra Leone 21, , and in Burundi it’s 1 in 22. In contrast, 1 in 45,200 women will die of maternal causes in Belarus.
Making progress in reducing maternal mortality
Many developing countries are making encouraging progress towards reducing MMR. But for most, however, progress is not fast enough to achieve the fifth Millennium Development Goal (MDG 5) of reducing by three quarters, between 1990 and 2015, the maternal mortality ratio. Achieving this target would require a 5.5% annual decline in MMR between 1990 and 2015.
The annual rate of decline by region ranges from 2.2% to 4.4 % between 1990 and 2013.
Women die from maternal causes such as severe bleeding (27%), high blood pressure during pregnancy (14%), infections (11%), obstructed labour and other direct causes (9%), unsafe abortion (8%), embolism (3%), and pre-existing medical conditions exacerbated by pregnancy (28%) (WHO). The pre-existing medical conditions (such as diabetes, malaria, HIV, obesity) cause as many deaths during pregnancy and childbirth as haemorrhage (severe bleeding).
Effort needs to be expanded and intensified in developing and implementing policies and strategies for effective maternal and reproductive health care.