Complications of pregnancy and childbirth are the leading causes of morbidity (illness) and mortality (death) among women of reproductive age in developing countries. There are approximately 529,000 pregnancy-related deaths worldwide each year.
There is a direct relationship between maternal death and infant and child survival. Approximately 7 million babies die each year before their first birthday (infant mortality), and about 50% of these deaths (3.4 million) occur at the time of delivery or during the first week of life. Maternal death also leaves over one million children motherless, which increases the risk of death for these children 3-10 times during the first two years. 25, 26
The highest incidence of pregnancy-related death occurs in the poorest countries in the world (countries in Africa and Asia), with sub-Sahara African having the highest rates. It is estimated that the life-time risk of maternal death there is one in 16, compared to one in 2,800 in developed countries. Pregnancy is the leading cause of death for young women ages 15-19 in developing countries.27
The following definitions are important in understanding maternal mortality:
- Maternal Mortality - death of a woman while she is pregnant, or within 42 days of termination of pregnancy regardless of the site or duration of the pregnancy.
- Maternal Mortality Ratio - the number of maternal deaths per 100,000 live births per year. The numerator includes deaths to women during their pregnancy or in the first six weeks after delivery. This measure is used conventionally rather than a rate because it is more accurate to use live births rather than total number of women to calculate the risk of death from pregnancy and childbirth.
- Maternal Mortality Rate - the number of maternal deaths per 100,000 women of reproductive age (15-49). This measures the impact of maternal deaths on the population of women as a whole but is generally not used in public health since not all women are at risk for maternal mortality--only those that are pregnant.
- Maternal Morbidity - refers to serious disease, disability or physical damage caused by pregnancy-related complications.
- Lifetime Risk of Maternal Death - the probability of dying as a result of pregnancy cumulative across pregnancies in a woman's life.
- Infant Mortality - the risk of an infant dying within the first year of life.
Obtaining accurate maternal death data is challenging in the developing world because accurate vital statistics are not available in many areas (particularly rural areas), and because the majority of births take place outside of health facilities. Instead of using vital statistics to track pregnancy related deaths, survey data is used instead. Thus, these data significantly underestimate the actual number of pregnancy-associated deaths.
The World Health Organization, the United Nations' Children's Fund and the United Nations Population Fund have developed a system to adjust existing data and provide estimates for countries lacking reliable data on maternal mortality. The table below provides a comparison of maternal mortality statistics throughout the developing and developed world.
|WHO/UNICEF/UNFPA Estimates of number of maternal deaths, lifetime risk and maternal mortality ratio, by MDG regions, for the year 2000.|
|MDG region||Number of maternal deaths *||Lifetime risk of maternal deaths - 1 in:||Maternal mortality ratio (maternal deaths per 100,000 live births)|
|- Northern Africa||4,600||210||130|
|- Sub-Saharan Africa||247,000||16||920|
|- Latin America and the Caribbean||22,000||160||190|
|- Eastern Asia||11,000||840||55|
|- South-central Asia||207,000||46||520|
|- South-eastern Asia||25,000||140||210|
|- Western Asia||9,800||120||190|
|* includes Canada, United States of America, Japan, Australia and New Zealand.|