Maternal deaths decline globally, but Covid-19 slowed progress

Despite decades of progress, maternal mortality has become a global health challenge. The improvements have been uneven with setbacks due to the pandemic.

In Short

• Maternal deaths fell significantly since 1990 but progress slowed recently
• Over 2.4 lakh women died from pregnancy-related causes in 2023 worldwide
• Covid-19 pandemic temporarily increased maternal deaths in 2020 and 2021

A major global study published in The Lancet has found that maternal deaths have fallen down quite a lot over the past three decades, but progress has slowed in recent years.

Besides, this progress remains uneven across countries.

Researchers estimate that about 2.4 lakh women died from pregnancy-related causes worldwide in 2023, highlighting that pregnancy and childbirth are still dangerous for many women, especially in low- and middle-income countries.

The study was conducted as part of the Global Burden of Disease 2023 analysis, which examined maternal mortality trends across 204 countries and territories between 1990 and 2023.

WHAT MATERNAL MORTALITY MEANS

Maternal mortality refers to deaths of women during pregnancy, childbirth, or within a year after delivery due to pregnancy-related causes.

Scientists measure this using the maternal mortality ratio (MMR), the number of maternal deaths for every 1 lakh live births.

Globally, the study estimates the MMR in 2023 was around 190 deaths per 1 lakh births.

Although this is a significant improvement from 1990, when the global ratio was more than 320 deaths per 1 lakh births, experts say the numbers are still far from safe levels in many parts of the world.

GLOBAL TARGET STILL FAR AWAY FOR MANY COUNTRIES

Under the United Nations Sustainable Development Goals (SDGs), countries aim to reduce maternal deaths to fewer than 70 deaths per 1 lakh births by 2030.

However, the study found that more than half the countries studied — 104 out of 204 — have not yet reached this target.

In many of these countries, maternal mortality remains very high, with some recording more than 140 deaths per 1 lakh births.

Researchers say progress that improved rapidly during the early 2000s has now slowed or even reversed in several regions since 2015.

COVID-19 PANDEMIC WORSENED MATERNAL DEATHS

The analysis also found that the Covid-19 pandemic temporarily increased maternal deaths in many parts of the world, particularly in 2020 and 2021.

During these peak pandemic years, health systems were overwhelmed and routine maternal care was disrupted. In some countries, pregnant women were also more vulnerable to severe Covid-19 infection.

Depending on the method used to estimate the impact, researchers believe the pandemic may have caused thousands to tens of thousands of additional maternal deaths globally.

WHAT ARE THE MAIN CAUSES

Most maternal deaths occur due to preventable complications during pregnancy and childbirth, including:

• Severe bleeding after delivery
• High blood pressure disorders like pre-eclampsia
• Infections
• Unsafe abortions
• Complications during labour

Experts say many of these deaths can be prevented through timely medical care, skilled birth attendants and access to emergency obstetric services.

INDIA'S PROGRESS OF MATERNAL HEALTH

India has made significant progress in reducing maternal deaths over the past two decades, largely due to improvements in institutional deliveries, maternal health programmes and better access to antenatal care.

According to the Sample Registration System (SRS), India’s maternal mortality ratio declined from around 556 deaths per 1 lakh births in 1990 to about 97 deaths per 1 lakh births in recent years.

While this represents a major improvement, India still needs further reductions to meet the SDG target of below 70.

Public health experts say continued investment in rural healthcare, skilled birth attendance, emergency obstetric care and maternal nutrition will be critical to sustain progress.

WHY DATA IS IMPORTANT

The researchers behind the Lancet study emphasised that reliable data is essential to track maternal deaths accurately.

In several countries, especially low-income settings, deaths are not always properly recorded, making it difficult to understand the true scale of the problem.

The study calls for stronger health surveillance systems, maternal death audits and better reporting to help governments design effective maternal health programmes.

Despite the progress seen since 1990, maternal mortality remains a major public health challenge worldwide.

For millions of women around the world, including many in developing countries, safe pregnancy and childbirth still depend heavily on the availability of timely medical care.

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