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• Reducing the number of women dying in childbirth by three-quarters by 2015 is one of the key goals of the Millennium Declaration. This goal was agreed by world leaders from 189 countries at the UN Millennium Summit in September 2000;

• Every minute, a woman dies from complications related to pregnancy and childbirth --- that means 1,600 deaths every day --- more than half a million deaths every year worldwide. In addition, for every woman who dies in childbirth, around 20 more suffer injury, infection or disease --- approximately 10 million women each year;

• 99 percent of these deaths occur in the developing world. The highest maternal mortality rates globally are in sub-Saharan Africa, followed by south-central Asia;

• Recent findings by WHO, UNICEF and the United Nations Population Fund (UNFPA) show that over her lifetime a woman living in sub-Saharan Africa has a one in 16 chance of dying in pregnancy or childbirth. This compares with a one in 2,800 risk for a woman from a developed region;

• Women are most at risk during childbirth in Sierra Leone and Afghanistan where one of six women will die from complications related to pregnancy and childbirth;

• In India alone, 136,000 women die in pregnancy and childbirth every year. Other high maternal mortality countries, in rank order, include Malawi, Angola, Niger, the United Republic of Tanzania, Rwanda, Mali and Somalia;

• Some one million children are left motherless each year as a result of maternal deaths. These children are three to 10 times more likely to die within two years than children who live with both parents;

• Women need not die in childbirth. The vast majority of maternal deaths could be prevented if women had access to --- and used --- skilled care during pregnancy, childbirth and the first month after delivery, or to quality family planning services, post-abortion care services and where permissible, safe abortion services;

• Finally, maternal mortality is a human rights and equity issue. Ensuring that mothers survive pregnancy and childbirth is fundamentally about women's rights and about creating a just and equitable society.

• The safest countries for delivering babies include Sweden, Iceland, Slovakia and Austria.

Up to 15 per cent of pregnant women in all population groups experience potentially fatal complications --- 20 million women each year;

• Five direct complications account for more than 70 percent of maternal deaths:

• Hemorrhage, 25 percent, is the most common cause of maternal death. If a mother's life is to be saved, it generally requires treatment within two hours at a health facility able to provide blood transfusions and perform other clinical measures;

• Infection, or sepsis, 15 percent, is a common result of poorly-performed abortions and unsterile procedures during delivery. It can also result from prolonged labor; when a woman's membranes have ruptured and she has not delivered within twenty-four hours. Serious infection usually results unless prevented by antibiotics;

• Unsafe abortion, 13 percent, abortion performed with unclean instruments and in unsanitary conditions, is the frequent result of unwanted pregnancy. Where abortion is illegal, women are often reluctant to seek medical care if they begin to hemorrhage or show signs of infection after undergoing the procedure, and consequently may die;

• Eclampsia, 12 percent, high blood pressure can lead to eclampsia (convulsions) during pregnancy, which can lead to death if not treated in its early stages. It can be detected and its complications prevented by competent pre-natal care;

• Obstructed labor, 8 percent, requires treatment at a hospital or equivalent facility that can perform operative delivery.

• Over 20 percent of women die as a result of diseases which are aggravated by pregnancy, such as malaria, anemia, TB and increasingly, HIV/AIDS. For example, more than 30 million women in Africa who become pregnant in malaria-endemic areas are at risk of malaria infection. Malaria increases the risk of dying either directly from severe malaria, or indirectly from malaria-related severe anemia;

• Not surprisingly, the underlying causes of maternal deaths are also responsible for the death of their babies. Newborns die or are disabled because of poor maternal health and lack of skilled care during pregnancy, birth and the first critical hours after birth; most newborn deaths are due to infections that occur either at birth (e.g. neonatal tetanus), or shortly after birth (e.g. pneumonia, diarrhea);

• Very young pregnant women are especially vulnerable to death during pregnancy and childbirth. Every year, 15 million babies are born to adolescent mothers, many of whom are not ready physically or emotionally for motherhood. They are twice as likely to die from childbirth as women in their twenties; those under the age of 15 are five times more likely to die.

• WHO is committed to achieving the Millennium Development Goal (MDG) of reducing by three-quarters, between 1990 and 2015, the number of women dying during pregnancy and childbirth; WHO has called for intensified action in addressing threats to maternal health;

• WHO assists countries with especially high rates of maternal deaths to strengthen their health systems to build a "continuum" of care so that all women and their babies can go through pregnancy, childbirth and the postnatal period safely --- irrespective of their ability to pay for these services;

• WHO has identified four key elements of this continuum of care for improving maternal and newborn health:

• Development of human resources: The skilled birth attendant,* working within a supportive health system, is the single most important factor in keeping women healthy and safe in pregnancy. However, globally only 62 percent of births are attended by a skilled attendant. In developing countries, the average figure is 53 percent; in some countries it is as low as 34 percent. By 2015, WHO aims to increase the proportion of births covered by skilled attendants to 90 percent globally --- that translates into providing skilled care to an additional 38 million women;

• Availability, access, use and quality of services: Health services for women and their newborns need to be widely available, easily accessible to all, widely used and of high quality;

• Capacities of women, families and the community: Self care by individuals, families and communities must be seen as part of the health system. Capacity for self care at home, and for making decisions about when to seek professional care (including the services of skilled attendants) must be expanded through health promotion, education and the involvement of communities in health issues;

• Collaborative links with other key primary health care programs: Ensuring that maternal and newborn care is an integrated component of primary health care, by strengthening collaborative links with other key primary health care programs e.g. HIV/AIDS, malaria, immunization, nutrition, health promotion, family planning, STI control, and the referral chain.


* A "skilled attendant" is a health professional --- a midwife, doctor or nurse --- who has been educated and trained to proficiency in the skills needed to manage normal deliveries and diagnose, manage or refer obstetric complications.




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