Deaths of Women During Pregnancy

Every day, hundreds of women across the world lose their lives due to complications related to pregnancy and childbirth. These deaths are not only tragic but, in most cases, entirely preventable. Maternal mortality—the death of a woman during pregnancy, childbirth, or shortly after delivery—is a grave public health issue that reflects the disparities in healthcare systems, education, gender equality, and socioeconomic conditions.

Understanding Maternal Mortality

Maternal mortality is defined by the World Health Organization (WHO) as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.

The global maternal mortality ratio (MMR) has significantly declined over the past decades, thanks to advancements in healthcare and increased awareness. However, the rate still remains unacceptably high, especially in low-income countries and among marginalized communities. According to WHO data, approximately 287,000 women  died from pregnancy-related causes in 2020. That translates to nearly 800 women every day—a deeply alarming figure.

Major Causes of Maternal Deaths

Maternal deaths can result from a wide variety of complications. The leading direct causes include:

1. Severe bleeding (hemorrhage): Particularly after childbirth, hemorrhage is one of the most common and immediate threats to a woman’s life during delivery.

2. Infections (sepsis): Poor sanitation, unsafe delivery practices, or delayed postnatal care can lead to infections that rapidly become life-threatening.

3. High blood pressure during pregnancy (pre-eclampsia and eclampsia): This condition can result in seizures, organ failure, or death if left untreated.

4. Obstructed labor: When labor is prolonged or the baby cannot pass through the birth canal, it may lead to uterine rupture or death if medical intervention is unavailable.

5. Unsafe abortions: In regions where access to safe abortion services is restricted, women may resort to unsafe procedures, resulting in fatal complications.

Additionally, indirect causes—such as malaria, anemia, HIV/AIDS, and heart disease—are also major contributors when they are exacerbated by pregnancy.

Global Disparities in Maternal Mortality

There is a stark contrast in maternal mortality rates between high-income and low-income countries. In sub-Saharan Africa, the MMR is about 545 deaths per 100,000 live births, compared to 12 deaths per 100,000 in high-income countries. The discrepancy is rooted in unequal access to quality healthcare, education, skilled birth attendants, and emergency obstetric care.

Women in rural areas or impoverished communities are often disproportionately affected. In many low-income settings, cultural practices, limited autonomy in reproductive decisions, and inadequate infrastructure compound the risks. Pregnant women may live miles away from a clinic, lack transportation, or have no money to afford care.

Socioeconomic and Cultural Factors

Maternal deaths are not just a result of medical failure—they are often intertwined with deep-rooted social and economic factors:

• Poverty: Poor women are more likely to be undernourished, have limited access to prenatal care, and live far from healthcare facilities.

• Education: Educated women are more likely to seek prenatal care, understand warning signs, and advocate for their health.

• Gender inequality: In many cultures, women do not have the autonomy to make decisions about their own bodies, including accessing healthcare or family planning.

• Early marriage and teenage pregnancy: Young girls face a higher risk  of complications and death due to immature physiology and lack of reproductive education.

The Role of Healthcare Systems

One of the most critical factors in preventing maternal deaths is access to skilled health professionals during pregnancy and childbirth. This includes doctors, nurses, and midwives who are trained in managing complications. Moreover, access to emergency obstetric care, including cesarean sections and blood transfusions, can be life-saving.

Unfortunately, in many low-resource settings, healthcare facilities are underfunded, understaffed, and ill-equipped. There may be no running water, no electricity, and a lack of essential medicines or surgical equipment.

Investing in primary healthcare infrastructure, training midwives, and ensuring the availability of maternal and newborn services is crucial to reducing maternal mortality.

The Importance of Family Planning

Access to contraception and reproductive health services is another vital strategy in reducing maternal deaths. Family planning allows women to avoid unplanned pregnancies, space births, and reduce the number of pregnancies they undergo—all of which can lower the risk of maternal complications.

However, millions of women globally lack access to effective contraception due to cultural stigma, religious opposition, or financial barriers. Expanding access to family planning services is essential for empowering women and protecting their lives.

Addressing Maternal Mental Health

Another often overlooked aspect of maternal mortality is mental health. Conditions such as perinatal depression, postpartum psychosis, and anxiety disorders can contribute indirectly to maternal deaths through suicide or neglect of self-care. Recognizing and treating mental health issues should be an integral part of maternal health services.

The Impact of COVID-19

The COVID-19 pandemic severely disrupted maternal healthcare services. Lockdowns, overburdened hospitals, and fear of infection led many women to delay or avoid prenatal visits and hospital births. As a result, maternal mortality rates rose in several countries during the pandemic. This exposed the fragility of healthcare systems and the need for resilient maternal care strategies in the face of future health crises.

Solutions and the Path Forward

Preventing maternal deaths requires a multi-faceted approach:

• Strengthening healthcare systems: Governments and NGOs must prioritize maternal health in national budgets, train skilled birth attendants, and ensure adequate supplies and infrastructure.

• Promoting education: Girls’ education, particularly in reproductive health, leads to informed choices and better pregnancy outcomes.

• Community involvement: Engaging local leaders, men, and families can shift harmful cultural norms and support pregnant women.

• Monitoring and accountability: Accurate data collection and transparent monitoring systems help identify gaps in care and target interventions effectively.

Global partnerships such as the United Nations Sustainable Development Goals (SDGs) have set a target to reduce the global MMR to less than 70 per 100,000 live births by 2030. While ambitious, this goal is achievable with concerted global effort.

Conclusion

The death of a woman during pregnancy or childbirth is not only a personal tragedy but a societal failure. It reflects the inequalities, neglect, and barriers that women face in accessing basic health rights. Most maternal deaths are preventable with timely medical care, access to reproductive services, and empowered communities.

Every life lost is one too many. Reducing maternal mortality must remain a global priority—not just as a health issue, but as a moral imperative to protect the rights and dignity of women everywhere.