A new World Health Organization (WHO) study has revealed that hemorrhage and hypertensive disorders, such as preeclampsia, remain the primary causes of maternal deaths globally. The report, released today, highlights that these conditions were responsible for approximately 80,000 and 50,000 deaths, respectively, in 2020, the most recent year for which estimates are available. The study underscores the ongoing disparities in access to life-saving care during pregnancy, childbirth, and the postpartum period.
Published in The Lancet Global Health, the WHO report serves as the first global update on maternal mortality since the adoption of the United Nations Sustainable Development Goals (SDGs) in 2015. While focusing on the major direct obstetric causes, the study also reveals that other health conditions, such as infectious and chronic diseases like HIV/AIDS, malaria, anaemia, and diabetes, contribute to nearly a quarter (23%) of pregnancy-related deaths. These conditions, often undiagnosed or untreated until complications arise, complicate pregnancies and pose significant risks to millions of women worldwide.
“Understanding why pregnant women and mothers are dying is critical to addressing the global maternal mortality crisis and ensuring women have the best possible chances of surviving childbirth,” said Dr. Pascale Allotey, WHO’s Director of Sexual and Reproductive Health and Research. “This is a global equity issue. Women everywhere need access to high-quality, evidence-based healthcare before, during, and after delivery, as well as efforts to prevent and treat underlying conditions that compromise their health.”
In 2020, an estimated 287,000 maternal deaths occurred globally, equating to one death every two minutes. Hemorrhage, particularly during or following childbirth, was responsible for nearly 27% of maternal deaths, while hypertensive disorders like preeclampsia contributed to an additional 16%. Preeclampsia, characterized by high blood pressure, can lead to severe complications, including hemorrhage, strokes, organ failure, and seizures if untreated or diagnosed too late.
Other direct causes of maternal mortality identified in the study include sepsis, infections, pulmonary embolism, complications from spontaneous and induced abortions (including miscarriage and unsafe abortion practices), and anesthetic complications during childbirth.
The study highlights the critical need to improve maternity care services, emphasizing the importance of antenatal care to detect risks early in pregnancy and prevent severe complications, as well as obstetric care to manage emergencies like hemorrhage and embolism. Postnatal care is also crucial, as most maternal deaths occur during or shortly after childbirth. However, around one-third of women, primarily in low-income countries, still lack access to essential postnatal care during the critical days after birth. Preventive interventions that target underlying health conditions such as noncommunicable diseases and malnutrition are also necessary to reduce maternal mortality rates.
Despite these findings, the report notes that data on some causes of maternal death, particularly maternal suicide, remains scarce. WHO calls for more comprehensive data collection, especially regarding late maternal deaths (those occurring in the year following childbirth), which are often linked to conditions that persist long after delivery. Many women also face barriers to accessing follow-up care, including mental health support.
WHO is working to improve access to high-quality, respectful maternity services across the continuum of pregnancy, childbirth, and postpartum care through research and evidence-based guidelines. In 2024, WHO and its partners launched the global Roadmap for Postpartum Haemorrhage, which outlines key priorities for tackling this leading cause of maternal death. Additionally, the World Health Assembly in 2024 passed a resolution urging countries to strengthen quality care before, during, and after childbirth.
Looking ahead, World Health Day 2025 will focus on maternal and newborn health, calling for intensified efforts to provide quality care for women and babies, particularly in the poorest countries and crisis settings where the majority of maternal deaths occur. The campaign will not only focus on survival but also advocate for broader attention to women’s health, including essential postnatal care and support.
The study, Global and Regional Causes of Maternal Deaths 2009-2020: A WHO Systematic Analysis, updates a previous analysis from 2014 and reveals that hemorrhage was also the leading cause of maternal death during the earlier period.
New estimates on global maternal deaths, including data for regional and country-level statistics, will be released in April 2025, covering the period from 2000 to 2023.
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