Explainer: Why maternal deaths continue to haunt

A recent United Nations report ranks India second in global maternal deaths, an alarming number despite the strides the country has made in reducing the maternal mortality ratio (MMR).

Globally, approximately one woman died every two minutes due to a maternal cause in 2023, notes the report titled ‘Trends in Maternal Mortality 2000-2023’. While Nigeria saw the highest number of maternal deaths in 2023, India ranked second, sharing the spot with the Democratic Republic of Congo; both accounted for 7.2 per cent each of global deaths.

The data highlights “how dangerous pregnancy still is in much of the world — despite the fact that solutions exist to prevent and treat the complications that cause the vast majority of maternal deaths”, says Dr Tedros Adhanom Ghebreyesus, the WHO director-general.

what the report says

In 2023, India accounted for 19,000 maternal deaths; 2.6 lakh women died worldwide — equivalent to over 700 maternal deaths every day.

key reasons

According to the report, women die as a result of complications during and following pregnancy and childbirth. Most of these complications develop during pregnancy, such as severe bleeding (mostly bleeding after childbirth), infections (usually after childbirth), high blood pressure during pregnancy, complications from delivery and unsafe abortion.

Dr Ghebreyesus terms maternal mortality “unacceptably high” as most of these complications are preventable or treatable.

Social determinants of health, such as income, education, access to high-quality healthcare with enough skilled providers, equipment, and medication; gender norms that devalue women and girls and limit their access to sexual and reproductive health care also influence maternal mortality.

india’s response

India’s maternal mortality ratio, the number of maternal deaths per 1 lakh births, dropped from 362 in 2000 to 80 in 2023, marking a decline of 78 per cent in the last two decades. The number of deaths came down to 19,000 in 2023 from 24,000 in the year 2000.

The Union Health Ministry says that India’s comparison with Nigeria is not fair owing to the difference of population. India’s population is 145 crore while Nigeria’s is only 23.26 crore. However, China, the one country that can be compared to India in population terms, saw 1,400 maternal deaths during the year.

impact of covid-19

In 2021, an estimated 40,000 more women died due to pregnancy or childbirth, taking the total number of deaths that year to 3,22,000 from 2,82,000 the previous year. This upsurge, the report says, was linked not only to direct complications caused by Covid-19, but also to widespread interruptions in health care services.

preventing deaths

All women, including adolescents, need access to contraception, safe abortion services to the full extent of the law, and quality post-abortion care. All women also need access to quality care in pregnancy, and during and after childbirth.

Maternal and newborn health are closely linked. It is particularly important that all births are attended to by skilled health professionals, as timely management and treatment can make the difference between life and death for the women as well as the newborns.

India