Health brief: One ‘unacceptable’ maternal death every two minutes
Since 2015 there has been a setback in reducing maternal deaths worldwide. While things are stagnating globally, some European countries, most notably Greece and Cyprus, are seeing an increase.
A report by United Nations (UN) agencies published last week (23 February) ‘Trends in maternal mortality’, revealed alarming setbacks for women’s health over recent years, as maternal deaths either increased or stagnated in nearly all regions of the world.
Between 2000 and 2015, there was significant progress in reducing maternal deaths but after this point, progress largely stalled or, in some cases, was even reversed.
In 2020, there were an estimated 287,000 maternal deaths worldwide, which translates into almost 800 deaths a day or one death every two minutes.
“This is unacceptable,” Jenny Cresswell, scientist and epidemiologist at the World Health Organisation (WHO) and author of the report, told a press briefing.
Worryingly, nearly all of these maternal deaths are due to preventable causes. “This is something we are very concerned about,” Cresswell stressed.
The death of a mother has an impact on the newborn and increases the risk of the newborn dying as well.
Furthermore, the report also found, for every woman who dies, between 15 to 30 women suffer a disability caused by pregnancy and childbirth-related complications, which can be serious lifelong complications that compromise productivity or quality of life.
Anshu Banerjee, assistant director general at Universal Health Coverage and the Life-course at WHO, highlighted that some 270 million women globally lack access to modern family planning methods as nearly half of all pregnancies are unintended.
“They’re unable to choose how and when to plan their families,” he stressed.
Family planning methods are just one side of the issue. Many women lack access to safe abortion, which increases the risk of complications, including deaths associated with unsafe procedures.
Finally, roughly a third of women globally do not have four of the recommended eight antenatal checks or do not receive essential postnatal care in the days and weeks after birth.
The European landscape
Within Europe, some countries have seen declines in maternal mortality but a number of countries have experienced increases.
The two countries in Europe region, which have seen statistically significant increases in maternal mortality of Greece and Cyprus. Despite the increase, both of these countries still have very low levels of maternal mortality.
For example, in Greece, in the year 2000, their maternal mortality ratio was four maternal deaths per 100,000, while in 2020, it was eight. These numbers are still relatively low when looking at the global picture, but researchers are calling for the trend to be reversed.
“Obviously, it is unacceptable that any woman is dying from a maternal death, and it is something which needs to be given a lot of attention to ensure that we can reverse this trend,” Cresswell said.
All about inequalities
The report also pointed out the inequalities seen globally both between and within countries when it comes to access to high-quality and respectful care, as well as sexual and reproductive rights and women’s autonomy.
“Globally, we see very substantial inequities between richer countries and poor countries and for subgroups within countries depend on characteristics and access to care,” Cresswell said.
The differences are striking: The number of maternal deaths per 100,000 live births in Sub-Saharan Africa in 2020 was estimated to be 545. This number is 136 times bigger than in Australia and New Zealand.
Europe and Northern America, Latin America, and the Caribbean are the regions where the maternal mortality rate increased from 2016 to 2020 by around 15%.
“Although in many of these countries, the absolute level of maternal mortality is low. This is the relative increase from a relatively low but absolute base,” Cresswell said.
She explained that the increase can be attributed ‘as a rule of thumb’ to access to quality, timely services, particularly around the time of delivery.
This can create obstacles to accessing quality care, either for the whole population or for subgroups within a population, and can lead to increased maternal mortality rates. Access to social security or health insurance, economic position, structural barriers and racial inequities all might have a role here.
“The reasons are complex, but the ultimate concern is lack of timely access to quality and perspective services,” Cresswell said.
Worldwide, the general trend is one of stagnation, with the exception of Australia and New Zealand, as well as Central and Southern Asia, which experienced significant declines in maternal mortality rates during the same period.
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