These conditions were responsible for around 80,000 and 50,000 deaths respectively in 2020 – the latest year for which published estimates are available – highlighting, according to the WHO, that «many women still lack access to life-saving treatments and effective care during and after pregnancy and childbirth.»
Published in the ‘Lancet Global Health’ journal, the study is the WHO’s first global update on the causes of maternal deaths since the adoption of the United Nations Sustainable Development Goals in 2015. In addition to outlining the main direct obstetric causes, it shows that other health conditions, including infectious and chronic diseases such as HIV/AIDS, malaria, anemia, and diabetes, account for nearly a quarter (23%) of pregnancy and childbirth-related mortality.
These conditions, often going unnoticed or untreated until significant complications arise, exacerbate the risk and complicate pregnancies for millions of women worldwide.
«Understanding why pregnant women and mothers die is essential to address the ongoing crisis of maternal mortality worldwide and ensure that women have the best possible chances of surviving childbirth,» said Pascale Allotey, Director of Sexual and Reproductive Health and Research at the WHO.
«This is also a major global equity issue: women worldwide need high-quality, evidence-based healthcare before, during, and after childbirth, as well as efforts to prevent and treat other underlying conditions that endanger their health,» added Allotey.
It is estimated that in 2020, there were a total of 287,000 maternal deaths, equivalent to one death every two minutes. This new WHO study reports that hemorrhages – occurring mainly during or after childbirth – account for almost a third (27%) of maternal mortality, and preeclampsia and other hypertensive disorders contribute an additional 16 percent.
Preeclampsia is a serious condition characterized by high blood pressure that can lead to hemorrhages, strokes, organ failure, and seizures if left untreated or treated too late.
Other direct causes include sepsis and infections; pulmonary embolism; complications from spontaneous and induced abortions – including miscarriages, ectopic pregnancies, and issues related to unsafe abortions – as well as anesthesia complications and injuries occurring during childbirth.
STRENGTHENING MATERNAL CARE
According to the WHO, the results underscore the need to strengthen key aspects of maternal care, such as prenatal services, which detect risks in the early stages of pregnancy and prevent severe complications; obstetric services, which can address critical childbirth-related emergencies like hemorrhages or embolisms, and postnatal care.
Most maternal deaths occur during childbirth or shortly after, making it a «critical moment» to save lives, notes the WHO. However, about a third of women – mainly in low-income countries – still do not receive essential postnatal checks in the days following childbirth.
The WHO believes that broader preventive interventions at the population level could help reduce the prevalence of underlying conditions – such as non-communicable diseases and malnutrition – that increase women’s risks.
«Preeclampsia, for example, can significantly increase the likelihood of hemorrhage, as well as other complications that can arise long after childbirth,» said WHO scientist and article author Jenny Cresswell.
«It has been shown that a more holistic approach to maternal health gives women the best chances of a healthy pregnancy and childbirth, and to enjoy a lasting quality of life after childbirth; healthcare systems need to support them throughout the various stages of life,» added Cresswell.
LACK OF DATA
The study is based on national data reported to the WHO, as well as expert-reviewed studies. For some causes, data remains limited. In particular, the authors call for more data on maternal suicide, currently only available for 12 countries.
Furthermore, the WHO points out that most countries do not report on late maternal deaths (those occurring in the year following childbirth), even though several conditions can pose risks long beyond childbirth itself. After childbirth, many women struggle to access follow-up care, including mental health support.
Therefore, the WHO is working to enhance access to «respectful» and «high-quality» services throughout pregnancy, childbirth, and postnatal care, through evidence-based research and guidelines. In 2024, the WHO and its partners launched a ‘Global Roadmap for Postpartum Hemorrhage’, outlining key priorities to address this significant cause of maternal death.
That same year, the 194 countries of the World Health Assembly approved a resolution committing to enhancing the quality of care before, during, and after childbirth. To drive action, World Health Day 2025 – marking five years since the deadline for the Sustainable Development Goals – will focus on maternal and neonatal health.
The campaign will call for intensified efforts to ensure women and newborns access high-quality, proven effective care, especially in the poorest countries and crisis situations, where the vast majority of deaths occur. Beyond survival, the campaign will also highlight the need to pay more attention to women’s health, including postnatal care and support.
