Over the past 25 years, the world has seen a dramatic decline in maternal deaths associated with pregnancy and childbirth. The latest report from the UN and the World Health Organization (WHO) states that maternal mortality fell by an incredible 43 percent since 1990. But it also found a few surprising results. For example, women are twice as likely to die from pregnancy- or childbirth-related complications in the U.S. than they are across the border in Canada.
While both countries have much lower maternal mortality rates than most of the rest of the world, the U.S. is still one of only 13 countries to report a worse mortality rate than 25 years ago, with other nations to make the list including North Korea and Zimbabwe. It’s not, however, an entirely clean slate for Canada either: While other developed nations have seen their death rates decrease, those in Canada are the same as they were in 1990.
From 532,000 maternal deaths globally in 1990, the WHO survey estimates that this number will be down to 303,000 by the end of the year, averaging at around 216 maternal deaths per 100,000 live births. One of the UN Millennium Development Goals is for this figure to be below 70 by 2030, with no individual country reporting more than 140 deaths per 100,000. But while the U.S. falls well below this target, it was still one of only a few nations that saw their mortality rate increase. From 1990 to 2015, the number of maternal deaths per 100,000 live births rose from 12 deaths to 14 – a 16.7 percent increase.
The reason for why the U.S. is bucking the trend is not easy to decipher, and is probably due to a number of causes. One possibility is the rise in the average age of mothers: As more women in their 30s and 40s are having babies, the risks associated with childbirth also increase. Another factor is the healthcare system: Uninsured pregnant women receive few prenatal care services, and thus are more likely to go into labor with underlying health problems.
America’s rate, however, pales in comparison to other nations. Shockingly, the maternal mortality rate in Sierra Leone, which has the unenviable title of being the most dangerous country in which to be a mother, is 1,360 per 100,000 births. If the global UN target is to be met, it would require the rate of reduction in maternal mortality to more than triple, from 2.3 percent per year (which has been occurring since 1990) to 7.5 percent per year.
There is a clear skew in where these deaths are occurring, though. Developing regions of the world accounted for an estimated 99 percent of all the global maternal deaths in 2015, with the rate per 100,000 jumping from an average of 12 in “developed” nations to 546 in sub-Saharan Africa, the area with the worst rates. Progress can be slow, but the UN target is still achievable. So far, nine countries have met the UN’s goal, reducing their mortality rate by between 78 and 90 percent, including Iraq, Mongolia, Rwanda, and Bhutan.