Key Takeaways
- In 2020, the global maternal mortality ratio (MMR) was 223 deaths per 100,000 live births, a decline from 227 in 2015 but still far from the Sustainable Development Goal target of less than 70 by 2030
- Sub-Saharan Africa accounted for roughly 70% of all maternal deaths globally in 2020, with an MMR of 533 per 100,000 live births
- In the United States, the maternal mortality rate rose to 32.9 deaths per 100,000 live births in 2021 from 23.8 in 2020, driven largely by deaths among Black women
- Only 55% of women in low-income countries receive at least four antenatal care visits, per WHO standards
- In rural India, 58% of pregnant women had first antenatal visit in first trimester in 2019-21, vs 79% urban
- Globally, 86% of women attended at least one antenatal care visit in 2020, up from 65% in 2000
- Postpartum hemorrhage affects 6% of deliveries worldwide, primary cause of maternal morbidity
- Hypertensive disorders like preeclampsia occur in 4-5% of pregnancies globally, leading to 14% of maternal deaths
- In the US, severe maternal morbidity rose 26% from 2013-2014 to 2019-2020, affecting 144 per 10,000 deliveries
- 94% of women worldwide have access to skilled birth attendants, but quality varies
- In the US, only 57% of postpartum women attend a follow-up visit within 21 days
- Postpartum depression screening occurs in 85% of US women at 1-3 months postpartum
- In low-income countries, women from poorest households are 3 times less likely to receive four antenatal visits
- Globally, rural women are 20% less likely to give birth with skilled attendant than urban
- In the US, Native American/Alaska Native women have MMR 3 times higher than white women
Maternal mortality rates remain dangerously high, especially in poor and conflict-affected regions.
Antenatal Care
- Only 55% of women in low-income countries receive at least four antenatal care visits, per WHO standards
- In rural India, 58% of pregnant women had first antenatal visit in first trimester in 2019-21, vs 79% urban
- Globally, 86% of women attended at least one antenatal care visit in 2020, up from 65% in 2000
- In Ethiopia, antenatal care coverage reached 74% for at least one visit in 2019, but only 41% for four visits
- US women with Medicaid insurance had 68% adequate prenatal care utilization in 2021, vs 85% private insurance
- In Nigeria, only 67% of pregnant women received antenatal care from skilled providers in 2018
- Bangladesh saw 82% of women with four or more antenatal visits in 2022, up from 26% in 2004
- In sub-Saharan Africa, 42% of women receive no antenatal care, leading to undetected complications
- Kenya's antenatal care first visit coverage is 96%, but quality remains low with only 51% getting four visits
- In Pakistan, 61% of rural women had no antenatal care in 2017-18
- Globally, iron deficiency anemia affects 40% of pregnant women, often undetected without antenatal screening
- In Brazil, 75% of pregnant women completed eight antenatal consultations in 2021, per Ministry of Health
- Afghanistan has only 19% of women receiving recommended antenatal care
- In the UK, 95% of women have at least one antenatal appointment by 12 weeks
- Uganda reports 58% coverage for four antenatal visits in 2022
- In China, 90% of urban pregnant women receive full antenatal care, vs 70% rural
- Tanzania's antenatal care coverage for first visit is 99%, but iron-folic acid receipt is only 68%
- In low-income countries, only 20% of antenatal visits include HIV testing
- Mexico achieved 91% antenatal care coverage in 2022, with focus on indigenous populations
- In South Africa, 83% of women had four antenatal visits in 2019, but gaps in syphilis screening persist
- Indonesia reports 89% first trimester antenatal visits in 2020
- In DR Congo, antenatal care coverage is 43% for four visits
- Globally, ultrasound coverage during antenatal care is only 44% in low-income settings
- Ghana's four-visit antenatal coverage rose to 87% in 2022
- In rural Nepal, 89% of women receive antenatal care, up from 69% in 2016
- US prenatal care initiation within first trimester is 78% overall, but 67% for American Indians
Antenatal Care Interpretation
Disparities and Inequalities
- In low-income countries, women from poorest households are 3 times less likely to receive four antenatal visits
- Globally, rural women are 20% less likely to give birth with skilled attendant than urban
- In the US, Native American/Alaska Native women have MMR 3 times higher than white women
- Sub-Saharan Africa has MMR 50 times higher than Europe
- In India, Scheduled Tribe women have 15% lower antenatal care coverage than others
- Adolescent mothers (15-19) face 50% higher risk of maternal death than women 20-24
- In Nigeria, northern regions have MMR twice that of south due to education gaps
- Globally, least developed countries account for 72% of maternal deaths despite 45% births
- Hispanic women in US have lower MMR than Black but higher cesarean rates
- In Ethiopia, poorest quintile has 10% antenatal coverage vs 68% richest
- Pakistan's rural-urban gap in skilled birth attendance is 25 percentage points
- Indigenous women in Australia have 2.3 times higher maternal mortality risk
- In Latin America, indigenous women have 2-4 times higher MMR
- Uneducated women globally 2 times less likely to access antenatal care
- In Brazil, Northeast region MMR 80 per 100k vs 30 in South
- Refugee women have 5 times higher obstetric complication rates
- In US, low-income women delay prenatal care by 2 weeks on average
- Yemen's conflict zones have 90% less access to emergency obstetric care
- In South Sudan, nomadic women have 70% lower healthcare access
- Globally, migrant women face 30% higher maternal morbidity due to barriers
- In Kenya, slum dwellers have MMR double that of formal areas
- Women with disabilities 2-3 times more likely to die from pregnancy complications
- In Ghana, northern rural women have 40% less postnatal care
- LGBTQ+ women report 20% higher discrimination in maternity care
- In Tanzania, coastal vs inland disparity in C-section access is 15%
Disparities and Inequalities Interpretation
Maternal Morbidity
- Postpartum hemorrhage affects 6% of deliveries worldwide, primary cause of maternal morbidity
- Hypertensive disorders like preeclampsia occur in 4-5% of pregnancies globally, leading to 14% of maternal deaths
- In the US, severe maternal morbidity rose 26% from 2013-2014 to 2019-2020, affecting 144 per 10,000 deliveries
- Obstetric fistula impacts 2 million women globally, mostly in sub-Saharan Africa, causing chronic morbidity
- Gestational diabetes prevalence is 14% worldwide, with 18% in Southeast Asia
- Sepsis during pregnancy affects 70 per 10,000 deliveries in low-resource settings
- In India, 20% of maternal near-misses are due to hemorrhage, per 2021 studies
- Eclampsia incidence is 1.4% in Latin America, contributing to neurological morbidity
- Uterine rupture occurs in 0.5-1% of vaginal births after cesarean, leading to hysterectomy in 36% cases
- Postpartum cardiomyopathy incidence is 1 in 2,000-4,000 US deliveries, higher in Black women
- Venous thromboembolism risk is 5-fold higher postpartum, affecting 1 in 1,600 deliveries
- In Nigeria, 30% of women experience obstetric violence during labor, causing psychological morbidity
- Amniotic fluid embolism occurs in 2-6 per 100,000 deliveries, with 60% maternal mortality
- Placenta accreta spectrum disorders increased 10-fold to 1 in 272 US deliveries by 2017
- In Ethiopia, 15% of postpartum women have depression, linked to obstetric complications
- HIV transmission risk without antenatal care is 15-45%, causing maternal AIDS morbidity
- Shoulder dystocia affects 0.6-1.4% of vaginal deliveries, leading to brachial plexus injury in 4-16%
- In Brazil, maternal near-miss ratio is 108 per 1,000 live births
- Perineal tears degree 3-4 occur in 1-3% of vaginal births, causing long-term incontinence
- Chorioamnionitis incidence is 1-5% in term pregnancies, higher with PROM
- In the UK, 50,000 women annually suffer severe maternal morbidity
- Anemia in pregnancy leads to 50% increased risk of postpartum hemorrhage
- Obstetric hemorrhage transfusion needed in 1.5% of deliveries globally
- Mental health disorders affect 10-20% postpartum, with 3% severe psychosis risk
- In South Africa, eclampsia causes 10% of severe maternal morbidity cases
- Globally, 27 million women experience disabling injuries from childbirth annually
Maternal Morbidity Interpretation
Maternal Mortality
- In 2020, the global maternal mortality ratio (MMR) was 223 deaths per 100,000 live births, a decline from 227 in 2015 but still far from the Sustainable Development Goal target of less than 70 by 2030
- Sub-Saharan Africa accounted for roughly 70% of all maternal deaths globally in 2020, with an MMR of 533 per 100,000 live births
- In the United States, the maternal mortality rate rose to 32.9 deaths per 100,000 live births in 2021 from 23.8 in 2020, driven largely by deaths among Black women
- India reported 97 maternal deaths per 100,000 live births in 2018-2020, down from 130 in 2014-2016, per National Family Health Survey
- Afghanistan's MMR stood at 620 per 100,000 live births in 2020, one of the highest globally due to conflict and limited healthcare
- In Ethiopia, maternal mortality decreased from 871 per 100,000 in 2000 to 267 in 2020 through community health programs
- The United Kingdom had a MMR of 13.4 per 100,000 live births in 2018-2020, with sepsis and thrombosis as leading causes
- Nigeria's MMR was 814 per 100,000 live births in 2020, contributing 19% of global maternal deaths
- In Brazil, MMR increased to 59.7 per 100,000 in 2019 from 44.7 in 2011, linked to rising cesarean rates
- Sierra Leone had the highest MMR at 1,120 per 100,000 live births in 2017, though recent data shows slight decline
- Globally, 287,000 women died from maternal causes in 2020, with hemorrhage causing 27% of deaths
- In the US, Black women face a MMR of 69.9 per 100,000 live births in 2021, 2.6 times higher than white women
- Pakistan's MMR was 186 per 100,000 in 2020, with rural areas at 231 vs urban 140
- Bangladesh reduced MMR from 574 in 2001 to 173 per 100,000 in 2016 via skilled birth attendant programs
- In South Sudan, MMR reached 1,150 per 100,000 live births in 2015, highest in the world at that time
- Kenya's MMR dropped to 342 per 100,000 in 2020 from 488 in 2014, per Demographic Health Survey
- Australia reported a MMR of 5.5 per 100,000 live births in 2017-2019, among the lowest globally
- DR Congo had MMR of 473 per 100,000 in 2020, with 25,000 maternal deaths annually
- In Japan, MMR is 4 per 100,000 live births, reflecting advanced healthcare systems
- Uganda's MMR was 336 per 100,000 in 2016, with postpartum hemorrhage as top killer
- Globally, adolescent girls aged 10-14 face 15 times higher MMR risk than women 20-24
- In California, MMR tripled from 6.1 to 18.6 per 100,000 between 1999-2005 and 2013-2017
- Tanzania's MMR fell from 556 to 208 per 100,000 from 2004 to 2022
- In Poland, MMR was 2.1 per 100,000 in 2020, one of Europe's lowest
- Yemen's MMR estimated at 164 per 100,000 in 2020 amid conflict
- In 2020, COVID-19 contributed to a 34% increase in MMR in some Latin American countries
- Ghana reduced MMR to 263 per 100,000 in 2020 from 319 in 2014
- In Sweden, MMR is 4.5 per 100,000 live births, with zero deaths from hemorrhage in recent years
- Somalia's MMR at 692 per 100,000 in 2020
- In New York City, MMR for Black non-Hispanic women was 92.1 per 100,000 in 2018-2020
Maternal Mortality Interpretation
Postpartum Care
- 94% of women worldwide have access to skilled birth attendants, but quality varies
- In the US, only 57% of postpartum women attend a follow-up visit within 21 days
- Postpartum depression screening occurs in 85% of US women at 1-3 months postpartum
- In India, 65% of women receive postnatal check within 2 days of discharge in 2019-21
- Globally, family planning needs are met for 77% of postpartum women within 2 years
- In Ethiopia, only 17% of women receive postnatal care within 24 hours
- UK postpartum care includes 28-day GP check for 90% of women
- In Nigeria, postnatal visit coverage is 42% within 48 hours
- Breastfeeding initiation within 1 hour occurs in 78% globally, but exclusive for 6 months only 44%
- In Bangladesh, 87% of women get postnatal care from skilled providers
- Sub-Saharan Africa has 51% postnatal care coverage within 2 days
- In the US, Black women are 50% less likely to have adequate postpartum visits
- Kenya reports 54% postnatal care within 24 hours in 2022
- In Pakistan, only 22% of rural women receive postnatal checks
- Australia has 95% postpartum follow-up rate at 6 weeks
- In Uganda, postnatal care coverage is 72% for first check
- Globally, 2.4 million newborns die in first month, many preventable with postpartum care
- In Brazil, 80% of women attend 1st postpartum consult within 42 days
- China reports 92% postnatal visit coverage in urban areas
- In Ghana, 76% receive postnatal care within 48 hours
- Tanzania has 62% postnatal care first visit coverage
- In low-income countries, only 61% of women receive postnatal care from skilled providers
- Mexico's postnatal care coverage is 89%, with focus on contraception
- In South Africa, 75% attend postnatal HIV services
- Indonesia reports 90% early postnatal checks in facilities
- Postpartum hemorrhage management with uterotonics reaches 87% in facilities globally
- In Nepal, 81% of women get postnatal care
- Black women in US have 1.5 times higher postpartum complication readmission rates
Postpartum Care Interpretation
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