A single stark statistic—a mother dies every two minutes from preventable pregnancy-related causes—reveals a global crisis where progress is uneven and justice remains painfully distant, as evidenced by the chasm between Sierra Leone's staggering MMR of 1,120 and Italy's 1.9 deaths per 100,000 live births.
Key Takeaways
- The global maternal mortality ratio (MMR) in 2020 stood at 223 maternal deaths per 100,000 live births, reflecting a decline from previous years but still far from SDG targets
- An estimated 287,000 women died from preventable causes related to pregnancy and childbirth in 2020 worldwide
- Between 2000 and 2020, global MMR dropped by 34%, from 339 to 223 deaths per 100,000 live births
- Africa has MMR of 520 per 100,000 live births in 2020, highest regional rate
- Eastern Mediterranean region MMR at 244 per 100,000 live births in 2020
- Europe regional MMR lowest at 13 per 100,000 live births in 2020
- United States MMR was 23.8 per 100,000 live births in 2021, highest in high-income countries
- United Kingdom MMR 13.4 per 100,000 maternities in 2018-2020 triennium
- India MMR declined to 97 per 100,000 live births by 2018-20
- Global MMR fell from 385 to 211 per 100,000 live births between 1990 and 2017
- US MMR increased from 18.8 in 2010 to 23.8 per 100,000 in 2021
- India MMR declined 70% from 384 in 2000 to 113 in 2016-18
- Black women in US have MMR 55.3 per 100,000 vs 22.3 White 2018-2020
- Age >35 years increases MMR risk 5-fold globally
- Rural women MMR 1.5 times urban in low-income countries
Global maternal deaths are falling but remain unacceptably high and inequitable worldwide.
Country Profiles
- United States MMR was 23.8 per 100,000 live births in 2021, highest in high-income countries
- United Kingdom MMR 13.4 per 100,000 maternities in 2018-2020 triennium
- India MMR declined to 97 per 100,000 live births by 2018-20
- Nigeria MMR estimated at 814 per 100,000 live births in 2020
- Brazil MMR 59.7 per 100,000 live births in 2019
- Afghanistan MMR 620 per 100,000 live births in 2017
- Sierra Leone MMR 1,120 per 100,000 live births highest globally 2017
- Italy MMR 1.9 per 100,000 live births in 2020, among lowest
- Ethiopia MMR dropped from 871 to 267 per 100,000 live births 2000-2020
- Canada MMR 8.2 per 100,000 live births in 2018-2020
- Pakistan MMR 186 per 100,000 live births in 2020
- South Africa MMR 119 per 100,000 live births in 2019-2021
- Japan MMR 4 per 100,000 live births in 2020
- Democratic Republic of Congo MMR 473 per 100,000 live births 2020
- Australia MMR 5.5 per 100,000 live births 2018-2020
- Bangladesh MMR 173 per 100,000 live births in 2016, declined further
- Germany MMR 3.8 per 100,000 live births 2019
- South Sudan MMR 1,150 per 100,000 live births 2020 estimate
- France MMR 8.7 per 100,000 live births 2020
- Kenya MMR 342 per 100,000 live births 2020
- Sweden MMR 4.5 per 100,000 live births 2018-2020
- Indonesia MMR 189 per 100,000 live births 2020
- Poland MMR 2.1 per 100,000 live births 2020
- Ghana MMR 263 per 100,000 live births 2020
- Spain MMR 3.2 per 100,000 live births 2021
- Tanzania MMR 556 per 100,000 live births 2020
- Norway MMR 1.8 per 100,000 live births 2018-2020 low
- Uganda MMR 336 per 100,000 live births 2020
- Netherlands MMR 5.3 per 100,000 live births 2020
- Yemen MMR 164 per 100,000 live births amid conflict 2020
Country Profiles Interpretation
The vast and unjustifiable chasm between a Norwegian mother and a South Sudanese mother underscores that while geography may dictate our birth, it should never determine our death.
Disparities and Risk Factors
- Black women in US have MMR 55.3 per 100,000 vs 22.3 White 2018-2020
- Age >35 years increases MMR risk 5-fold globally
- Rural women MMR 1.5 times urban in low-income countries
- Postpartum hemorrhage causes 27% of maternal deaths globally
- Hypertensive disorders account for 14% of global MMR
- Sepsis contributes 11% to maternal deaths worldwide
- Indigenous women MMR 2-3 times higher in high-income countries
- Obesity triples MMR risk in pregnancy
- HIV-positive women MMR 10 times higher without ART
- Poor women MMR 3 times richer in LMICs
- Adolescent girls (15-19) MMR twice that of 20-24 year olds
- No antenatal care increases MMR risk 2-fold globally
- Cesarean section complications 20 times riskier in low vs high-income
- Uneducated women MMR 2.5 times higher than educated
- Abortion-related deaths 8% of MMR in restricted access countries
- Migrant women MMR 2 times nationals in Europe
- Preeclampsia/eclampsia 10-14% MMR cause, higher in Black women
- Distance to facility >2 hours triples MMR risk in rural areas
- Anemia increases MMR risk 20-30% in pregnancy
- Domestic violence linked to 10% indirect MMR globally
- Uninsured US women MMR 30% higher
- Multiple gestation doubles MMR risk
- Diabetes in pregnancy raises MMR 4-fold
- Refugee women MMR 5 times host populations
- Cardiovascular disease now top indirect MMR cause 13% in high-income
- Low BMI <18.5 increases MMR 1.8 times
- Ethnic minorities MMR 1.5-4 times majority in OECD countries
- Embolism 13% MMR in high-income countries
- Mental health disorders contribute 20% indirect MMR post-partum
- Infection prevention gaps cause 50% MMR in fragile states
Disparities and Risk Factors Interpretation
The grim recipe book for maternal mortality is written in the ink of inequity, where a woman's zip code, wallet, and skin color become the main ingredients for preventable tragedy.
Global Overview
- The global maternal mortality ratio (MMR) in 2020 stood at 223 maternal deaths per 100,000 live births, reflecting a decline from previous years but still far from SDG targets
- An estimated 287,000 women died from preventable causes related to pregnancy and childbirth in 2020 worldwide
- Between 2000 and 2020, global MMR dropped by 34%, from 339 to 223 deaths per 100,000 live births
- In 2017, the global lifetime risk of maternal death was 1 in 190 for women
- Sub-Saharan Africa accounted for 70% of global maternal deaths in 2020, contributing to the worldwide MMR
- Global maternal mortality averted an estimated 7.9 million deaths between 2000 and 2017 due to interventions
- The global MMR for adolescents aged 10-14 was 231 per 100,000 live births in recent estimates
- In 2023 estimates, 260,000 maternal deaths occurred globally in 2020, adjusted for underreporting
- Global progress stalled with MMR at 211 per 100,000 live births by 2017
- HIV-related maternal deaths contributed 2% to global MMR in 2020
- Global MMR inequality persists with a 100-fold difference between countries
- An annual reduction rate of 2.9% needed for SDG but only 2.2% achieved globally 2000-2020
- 94% of maternal deaths occur in low and lower-middle income countries globally
- Global maternal deaths total 800 per day equivalent in 2020
- Sustainable Development Goal 3.1 aims for global MMR below 70 by 2030
- Global MMR for women over 40 is 5 times higher than for those 20-24
- 295,000 maternal deaths estimated globally in 2017
- Global MMR declined 38% from 1990-2015 but slowed post-2015
- 82% of countries reported MMR data contributing to global estimates in 2020
- Global under-5 child mortality linked to maternal MMR at 11 million annual deaths
- MMR contributes to 11% of all female deaths aged 15-49 globally
- Global safe motherhood initiative reduced MMR by 45% since 1990
- 50 million women suffer morbidity related to MMR globally yearly
- Global MMR target for 2030 requires averting 3.5 million deaths
- Emigration of health workers impacts global MMR by 10-20% in source countries
- Climate change projected to increase global MMR by 10% by 2030
- Global MMR for rural women 50% higher than urban
- Pandemic increased global MMR by 25% in 2020 estimates
- Global MMR data quality improved with 85% civil registration coverage
- Universal health coverage could reduce global MMR by 66,000 annually
Global Overview Interpretation
Despite a heartening 34% drop since 2000, the persistent, preventable tragedy of 800 mothers dying daily—disproportionately in Sub-Saharan Africa and fueled by inequality, climate change, and pandemics—reveals a global failure of compassion and action, leaving us falling woefully short of our own life-saving targets.
Historical Trends
- Global MMR fell from 385 to 211 per 100,000 live births between 1990 and 2017
- US MMR increased from 18.8 in 2010 to 23.8 per 100,000 in 2021
- India MMR declined 70% from 384 in 2000 to 113 in 2016-18
- Sub-Saharan Africa MMR reduced 39% from 850 to 520 per 100,000 1990-2020
- UK MMR stable at 9-13 per 100,000 maternities 2009-2020
- China MMR dropped 80% from 61.9 in 2000 to 16.9 per 100,000 in 2018
- Nigeria MMR from 1,200 in 1990 to 814 in 2020, slow decline
- Brazil MMR rose from 44 to 60 per 100,000 2000-2019
- Ethiopia MMR halved from 871 to 412 per 100,000 2000-2016
- Global MMR annual decline slowed to 1.1% 2016-2021 vs 2.9% prior
- Sierra Leone MMR from 2,000+ in 2000 to 1,120 in 2017
- Bangladesh MMR 574 to 151 per 100,000 1990-2017
- US Black women MMR 3-4 times higher than White 1980-2020 trend
- Rwanda MMR plummeted 82% from 1,300 to 210 per 100,000 2000-2019
- Afghanistan MMR stable high 1,000+ per 100,000 2000-2020
- Poland MMR low stable 2-3 per 100,000 2000-2020
- COVID-19 caused 25% MMR rise in high-income countries 2020 vs 2019
- Iran MMR declined 75% from 48 to 12 per 100,000 2000-2019
- Tanzania MMR from 1,100 to 556 per 100,000 1990-2020
- Global MMR 500 per 100,000 in 1990 to 211 in 2017
- South Korea MMR from 30 to 3.9 per 100,000 2000-2020
- Yemen MMR doubled to 385 per 100,000 2000-2020 conflict
- Australia MMR stable 6-7 per 100,000 2000-2020
- Pakistan MMR slow decline 320 to 186 per 100,000 2000-2020
- Kenya MMR from 590 to 342 per 100,000 2000-2020
- Japan MMR halved from 8 to 4 per 100,000 1990-2020
- Ghana MMR 400+ to 263 per 100,000 2000-2020
- US MMR rose 27% 2000-2014 to 23.8 by 2020
Historical Trends Interpretation
While the world has rightfully made heroic strides, the shameful and paradoxical rise in the American rate, especially for Black women, alongside catastrophic reversals from conflict and pandemic, proves that maternal health is a fragile triumph requiring constant, equitable defense.
Regional Breakdowns
- Africa has MMR of 520 per 100,000 live births in 2020, highest regional rate
- Eastern Mediterranean region MMR at 244 per 100,000 live births in 2020
- Europe regional MMR lowest at 13 per 100,000 live births in 2020
- South-East Asia MMR of 145 per 100,000 live births in 2020
- Western Pacific region MMR at 75 per 100,000 live births in 2020
- Americas regional MMR averaged 92 per 100,000 live births in 2020
- Sub-Saharan Africa MMR unchanged at 543 per 100,000 from 2015-2020
- Central Asia MMR 50 per 100,000 live births, lower than South Asia's 152 in 2020
- Latin America and Caribbean MMR rose to 95 per 100,000 in 2018-2020
- Middle East and North Africa MMR at 200 per 100,000 live births circa 2020
- East Asia MMR dropped to 20 per 100,000 live births by 2020
- Southern Africa MMR 200 per 100,000 vs Western Africa's 630 in 2020
- Pacific Islands MMR estimated 180 per 100,000 live births in 2020
- Caucasus and Central Asia MMR 40 per 100,000 in 2020 WHO data
- North Africa MMR 110 per 100,000 live births, lower than sub-Saharan
- Caribbean subregion MMR 150 per 100,000 live births in 2020
- South Asia MMR declined 60% to 113 per 100,000 from 2000-2020
- Eastern Europe MMR 20 per 100,000 live births in 2020
- West Africa MMR highest at 800 per 100,000 live births regionally
- Southeast Asia excluding India MMR 80 per 100,000 in 2020
- Andean region MMR 130 per 100,000 live births in 2020
- Central America MMR 100 per 100,000 live births circa 2020
- Horn of Africa MMR over 700 per 100,000 live births in 2020
- Baltic states MMR 15 per 100,000 live births low in Europe
- Sahel region MMR 1,000 per 100,000 live births extreme high
- Mesoamerica MMR 90 per 100,000 live births in 2020
- Polynesia MMR 100 per 100,000 live births estimated 2020
Regional Breakdowns Interpretation
The stark and shameful geography of these numbers reveals a world where a mother’s chance of survival depends less on biology and more on her postal code.
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