Maternal Mortality: Global Decline Slows, New Research Shows

Global maternal deaths have declined significantly over the past three decades, but that progress has stalled in recent years, and a new analysis reveals a stark disparity: more than 100 countries are not on track to meet the global target for maternal mortality. The findings, published in March 2026 in The Lancet Obstetrics & Gynaecology & Women’s Health as part of the Global Burden of Disease (GBD) Study 2023, underscore the urgent need for renewed efforts to improve maternal health worldwide.

Uneven Progress and Persistent Disparities

The GBD 2023 research builds on decades of data collection and analysis, providing a comprehensive picture of maternal mortality across the globe. While the overall trend shows a reduction in deaths related to pregnancy and childbirth – from an estimated 531 deaths per 100,000 live births in 1990 to 223 deaths per 100,000 in 2023 – the rate of decline has slowed considerably since 2010. This slowdown is particularly pronounced in regions already facing significant health challenges, including sub-Saharan Africa and South Asia. The study highlights that progress isn’t uniform; some countries have made substantial gains, while others are lagging far behind.

Maternal mortality refers to the death of a woman during pregnancy or within 42 days of the complete of pregnancy, regardless of the duration and site of the pregnancy. Causes are varied, but include severe bleeding, infection, high blood pressure during pregnancy (pre-eclampsia and eclampsia), unsafe abortion, and underlying medical conditions exacerbated by pregnancy.

The Global Burden of Disease Study: A Deep Dive

The Global Burden of Disease (GBD) study is a massive, collaborative effort led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. It involves researchers from over 150 countries and territories and aims to quantify the health loss from diseases, injuries, and risk factors. GBD 2023 provides estimates for 375 diseases and injuries, and analyzes the impact of 88 risk factors. The study utilizes data from a variety of sources, including vital registration systems, household surveys, and health facility records. It calculates key metrics like years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) to provide a comprehensive measure of health burden. You can explore the data and visualizations from GBD 2023 through the GHDx Data Resources.

What the Numbers Reveal: Regional Variations

The GBD 2023 data reveals significant regional differences in maternal mortality rates. Sub-Saharan Africa continues to bear the highest burden, with rates far exceeding the global average. While progress has been made in some countries within the region, challenges remain, including limited access to quality healthcare, poverty, and political instability. South Asia also faces a substantial burden, although rates are generally lower than in sub-Saharan Africa. High-income countries generally have the lowest maternal mortality rates, but even within these regions, disparities exist based on socioeconomic status and access to care.

The study also examines the changing landscape of maternal health, noting a shift from communicable, maternal, neonatal, and nutritional diseases to a rising burden of noncommunicable diseases and their associated risk factors. This epidemiological transition has implications for maternal health, as women with pre-existing conditions like hypertension and diabetes are at increased risk of complications during pregnancy.

Understanding the Limitations of the Data

It’s important to acknowledge the limitations inherent in studies like the GBD 2023. Data quality varies significantly across countries, with some nations lacking robust vital registration systems. This can lead to underreporting of maternal deaths, particularly in remote or underserved areas. The study relies on modeling and statistical techniques to estimate maternal mortality rates in countries with limited data, which introduces a degree of uncertainty. The GBD study focuses on quantifying the burden of disease, but it does not necessarily identify the specific causal factors driving maternal mortality in each context. Correlation does not equal causation, and the study highlights associations between risk factors and maternal deaths, but cannot definitively prove that one causes the other.

Beyond the Numbers: The Importance of Context

Maternal mortality is not simply a health issue; We see deeply intertwined with social, economic, and political factors. Poverty, lack of education, gender inequality, and limited access to healthcare all contribute to the risk of maternal death. Conflict and displacement can disrupt healthcare services and exacerbate existing vulnerabilities. Addressing these underlying determinants of health is crucial for improving maternal outcomes. For example, high systolic blood pressure, particulate air pollution, high blood sugar, smoking, and low birthweight are identified as top five risk factors accounting for 8.4 percent of total DALYs, according to the GBD 2023 findings.

What Comes Next: Surveillance, Review, and Guidance

The findings from the GBD 2023 study will inform ongoing efforts to improve maternal health globally. The World Health Organization (WHO) and other international organizations regularly review the evidence and update their guidance on maternal healthcare. These guidelines cover a range of interventions, including antenatal care, skilled birth attendance, emergency obstetric care, and postpartum care. Strengthening health systems, training healthcare workers, and ensuring access to essential medicines and supplies are also critical components of a comprehensive maternal health strategy. Continued surveillance of maternal mortality rates is essential for tracking progress and identifying areas where further investment is needed. National governments are expected to use this data to refine their own maternal health policies and programs, focusing on the areas where the greatest impact can be made.