Maternal deaths fell 40% since 2000, but fragile states now drive most

The world has cut maternal deaths substantially this century, but the deaths that remain are increasingly concentrated in the hardest places to reach. Between 2000 and 2023 the global maternal mortality ratio fell by about 40%, and yet about 260,000 women still died during or after pregnancy and childbirth in 2023 — the equivalent of a maternal death almost every two minutes [s1].

The estimates come from the UN Maternal Mortality Estimation Inter-Agency Group — WHO, UNICEF, UNFPA, the World Bank Group and the UN Population Division — whose latest report covers the period 2000 to 2023 [s2]. Against the Sustainable Development Goal target of fewer than 70 maternal deaths per 100,000 live births by 2030, the world remains far off track, and progress has been uneven to the point of injustice [s2].

The geography of a preventable death

Just over 90% of all maternal deaths in 2023 occurred in low- and lower-middle-income countries [s1]. Sub-Saharan Africa and southern Asia together accounted for around 87% — roughly 225,000 deaths — with sub-Saharan Africa alone carrying about 70% (182,000) and southern Asia about 17% (43,000) [s1]. The gap between rich and poor is stark: the maternal mortality ratio in low-income countries in 2023 was 346 per 100,000 live births, against 10 per 100,000 in high-income countries [s1].

None of that means the poorest regions have stood still. Sub-Saharan Africa, despite its very high ratio, cut its own maternal mortality ratio by 40% between 2000 and 2023, and the largest fall in the lifetime risk of maternal death occurred in central and southern Asia, where the risk dropped 83% — from 1 in 71 in 2000 to 1 in 410 in 2023 [s1]. Some regions posted even steeper ratio declines: eastern Europe cut its maternal mortality ratio 75% (from 38 to 9), and southern Asia 71% (from 405 to 117) [s1]. The lesson is that fast progress is possible; the problem is that it has not reached everyone.

The progress on lifetime risk was broad enough to reshape whole regions. In five of them — sub-Saharan Africa, northern Africa and western Asia, Australia and New Zealand, eastern and south-eastern Asia, and Oceania excluding Australia and New Zealand — a woman's lifetime risk of dying from a maternal cause more than halved between 2000 and 2023 [s1]. That is the kind of change that follows expanded antenatal care, more births attended by skilled professionals, and better emergency care around childbirth [s1]. The tools are known and comparatively cheap; the question the data keep returning to is who gets them.

Where the deaths now cluster

The most consequential finding is about fragility. In 2023, 37 countries classified as being in conflict or in institutional or social fragility accounted for 61% of all maternal deaths worldwide, despite being home to only about 25% of global live births [s1]. The maternal mortality ratio in conflict-affected areas was 504 per 100,000 live births — many times the rate in stable, high-income settings [s1]. Maternal deaths, in other words, have become a barometer of where health systems have broken down: where skilled birth attendance, emergency obstetric care, blood supplies and safe transport are hardest to guarantee.

That framing matters for what happens next. Almost all maternal deaths are preventable with care before, during and after childbirth from skilled health professionals [s1]. The recent slowing of global progress, and the concentration of deaths in fragile and conflict-affected states, point to a blunt conclusion: further gains depend less on new medical knowledge than on sustaining and protecting basic maternity services in the places where they are most fragile — and most easily lost [s1][s2].

This article is informational and is not medical advice.

Sources

• [s1] World Health Organization, "Maternal mortality" (fact sheet), 7 April 2025. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality
• [s2] WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division, "Trends in maternal mortality 2000 to 2023," 7 April 2025. https://www.who.int/publications/i/item/9789240108462