A woman died every two minutes because of pregnancy or childbirth in 2020, according to a new World Health Organization report that shows the stark persistence of preventable maternal deaths over the past two decades.
From 2016 to 2020, maternal mortality rates stagnated in the majority of countries, the report shows.
But they rose in 17 countries. In the United Nations-designated regions encompassing Europe and Northern America, maternal mortality rates increased by 17% from 2016 to 2020. In Latin America and the Caribbean, they increased by 15%.
“While pregnancy should be a time of immense hope and a positive experience for all women, it is tragically still a shockingly dangerous experience for millions around the world who lack access to high quality, respectful health care,” said WHO Director-General Tedros Adhanom Ghebreyesus.
The new report, which features data collected from 185 countries and territories from 2000 to 2020, shows the degree to which progress in confronting maternal mortality has stalled.
An estimated 287,000 maternal deaths occurred in 2020, the report found — defined as deaths that occur because of pregnancy- or childbirth-related complications, during pregnancy or within six weeks after pregnancy ends.
But that number does not account for the full scope of the coronavirus pandemic’s impacts, which research suggests have been significant: Covid-19 was a contributing factor in 25% of maternal deaths in the U.S. in 2020 and 2021, according to a government report released last fall.
“The weaker the health system is before a disaster, the more it’s impacted afterwards,” said Dr. Willibald Zeck, the chief of sexual and reproductive health and rights at the United Nations Population Fund.
About 70% of the estimated maternal deaths in 2020 occurred in sub-Saharan Africa, the WHO report found.
In nine countries facing humanitarian crises, there were 551 maternal deaths per 100,000 live births, more than double the global average. The list includes Afghanistan, where the Taliban have eroded women’s rights since they seized power in 2021, and both the Democratic Republic of the Congo and South Sudan, where conflicts have displaced millions.
Meanwhile, maternal mortality rates decreased by 35% in Australia and New Zealand and by 16% in central and southern Asia from 2016 to 2020.
Thirty-one other countries also had decreases in their maternal mortality rates. Zeck said those places are more likely to have universal health care systems, empowered health care workforces that often include midwives, resources to ensure comprehensive medical care and lower rates of cesarean sections, which can be harmful when not medically necessary, according to WHO research.
Most maternal deaths are preventable. They are caused by severe bleeding, high blood pressure, complications from unsafe or inaccessible abortions and underlying conditions, including HIV/AIDS and malaria.
More than 1 million additional maternal deaths will occur by 2030 if current trends continue, the WHO report estimates.
Solutions suggested in the report include strengthening health care systems by hiring more workers, ensuring access to sexual and reproductive health services and investing broadly in women's health and education.
Zeck said ensuring equity in external factors that contribute to health — including economic security and education access — is also key to rectifying health disparities based on race and class. In the U.S., for example, Black women have historically had the highest maternal mortality rates.
Globally, about a third of women do not receive four of the recommended eight prenatal checkups or postnatal care, and 270 million women lack access to contraception, according to WHO data.
Some experts fear that abortion restrictions in the U.S. could spur maternal mortality rates to rise further.
"We have the tools, knowledge and resources to end preventable maternal deaths; what we need now is the political will," Dr. Natalia Kanem, the executive director of the U.N. Population Fund, said in a statement.