Maternal health

Important progress has been made over the past three decades, but there is a long way to go.

While maternal mortality has declined by 34 per cent since 2000, recent data show that progress has stalled since 2015. In 2020, an estimated 287,000 women died of causes related to pregnancy or childbirth. Around 70 per cent lived in sub-Saharan Africa. A majority of them died from severe bleeding, sepsis, pre-eclampsia, obstructed labour and the complications of unsafe abortions – all causes for which there are highly effective interventions. 

When mothers die, their families are much more vulnerable, and their infants are more likely to die before their second birthday.

Working for the survival of mothers is a key development priority. The International Conference on Population and Development called for achieving a 75 per cent reduction in maternal mortality between 1990 and 2015; this remains an unfinished agenda. The Sustainable Development Goals, also known as the Global Goals, call for bringing the global maternal mortality ratio down to 70 deaths per 100,000 live births by 2030. Some South Asian countries and many sub-Saharan African countries are not on track to reach that target. 

The best way to achieve this ambitious goal is to ensure that all women have access to contraception to avoid unintended pregnancies; to provide all pregnant women with skilled and respectful care in a safe environment during delivery; and to make sure women with complications have timely access to quality emergency obstetric care.

While 83 per cent of reporting countries have established national targets for reducing maternal and newborn mortality rates, only 61 per cent have costed plans, and only 12 per cent of plans are fully funded.

Antenatal care is an important part of basic maternal health care. Expectant mothers should receive at least eight antenatal care visits, in which a health worker can check for signs of ill health – such as being underweight or having anaemia, hypertension or infection – and monitor the health of the fetus. 

During these visits, women are counselled on nutrition and hygiene to improve their health prior to, and following, delivery. UNFPA and the World Health Organization strongly recommend that health workers develop a birth preparedness and complication readiness plan, an essential component of antenatal care, which lays out how to receive care and what to do in case of an emergency.

Because these visits may be a woman’s first interaction with the health system, they are an important opportunity to support her in enacting her sexual and reproductive health and rights, while assessing her overall health. Women can be advised on choosing a modern contraceptive method appropriate for them and learn about the health benefits of spacing births and how to plan their families. They are also counselled on newborn care, post-delivery family planning and the importance of birth registration.

Nonetheless, the great majority of obstetric complications are unpredictable, arising with little or no warning among women with no risk factors. While antenatal visits may not prevent most complications, some can be identified and addressed in a timely manner, and women who receive antenatal care are more likely to deliver with the help of a skilled birth attendant who can recognize and address these issues.

Emergency obstetric care is critical to reducing maternal mortality. All five of the major direct causes of maternal death – haemorrhage, sepsis, unsafe abortion, hypertensive disorders and obstructed labour – can be treated at a well-staffed, well-equipped health facility. In such settings, most newborns with asphyxia or infection can also be saved.

In case of complications, all women and newborns should have rapid access to well-functioning emergency obstetric facilities that meet good quality-of-care standards. And in the long term, all births should take place in appropriate facilities, as is the case in all countries that have managed to significantly reduce their maternal mortality.

Postnatal care – provided within the first 24 hours of delivery, followed by the third day after delivery, then in the second and sixth weeks – is as important as antenatal care. Bleeding, sepsis and hypertensive disorders can all occur after a woman leaves the health facility. Newborns are also extremely vulnerable in the immediate aftermath of birth. UNFPA, the World Health Organization and UNICEF strongly recommend follow-up visits by a health worker to assess both mother and child in the postnatal period.

Making motherhood safer is a top priority for UNFPA, and we work at all levels to promote universal access to sexual and reproductive health care and rights, including by promoting international maternal health standards and providing guidance and support to health systems.

UNFPA-supported programmes strengthen human resources, emergency obstetric and newborn care, and respectful and human-centred quality care. Among its many programmes and through its flagship Maternal and Newborn Health Thematic Fund, UNFPA helps to train midwives, supports emergency obstetric and newborn care facilities and networks, and provides essential drugs and family planning services. UNFPA also supports the implementation of maternal death review and response systems, which help officials understand how many women are dying and why, as well as how to respond.

UNFPA also leads the global Campaign to End Fistula to intensify efforts to ensure that every woman has access to high-quality maternal health services. Worldwide, 500,000 women and girls live with obstetric fistula, one of the most severe, debilitating and socially isolating childbirth injuries. UNFPA has directly supported more than 40,000 women through fistula repair surgery, while 13,870 fistula survivors have received comprehensive reintegration and rehabilitation support; 71 percent of supported countries now have a national strategy to end fistula.  

UNFPA additionally seeks to make pregnancy and childbirth as safe as possible in humanitarian emergency settings. 

Updated on 24 November 2024