Breathe
By Gabriela Sotomayor
Women's right to health is a separate issue. Much remains to be done in favor of women in a basic issue: pregnancy.
For example, hemorrhage (heavy and severe bleeding) and hypertensive disorders such as preeclampsia are the leading causes of maternal death worldwide, according to a new study published by the World Health Organization (WHO). These conditions were responsible for about 80 000 and 50 000 deaths respectively in 2020 (the latest year for which published estimates are available), according to a new study published by the World Health Organization (WHO). published estimates ), highlighting that many women still lack access to life-saving treatment and effective care during and after pregnancy and childbirth.
The study, published in The Lancet Global Health, is WHO's first global update on the causes of maternal deaths since the United Nations Sustainable Development Goals were adopted in 2015. In addition to describing the main direct obstetric causes, it shows that other health conditions, including infectious and chronic diseases such as HIV/AIDS, malaria, anemias, and diabetes, account for nearly a quarter (23%) of pregnancy- and childbirth-related mortality.
These conditions, which often go undetected or untreated until major complications occur, exacerbate the risk and complicate pregnancies for millions of women worldwide.
"Understanding why pregnant women and mothers die is critical to addressing the world's persistent maternal mortality crisis and ensuring that women have the best chance of surviving childbirth," says Dr. Pascale Allotey, Director of Sexual and Reproductive Health and Research at WHO, as well as the UN Special Programme on Human Reproduction (HRP).
"This is also a huge global equity issue: women around the world need high-quality, evidence-based health care before, during and after childbirth, as well as efforts to prevent and treat other underlying conditions that jeopardize their health," she argues.
In 2020, there were an estimated 287 000 maternal deaths in total, equivalent to one death every two minutes. This new WHO study reports that hemorrhage, which occurs mainly during or after childbirth, is responsible for nearly one-third (27%) of maternal mortality, with preeclampsia and other hypertensive disorders contributing an additional 16%. Preeclampsia is a serious condition characterized by high blood pressure that can lead to hemorrhage, stroke, organ failure, and seizures if left untreated or treated too late.
Other direct causes include: sepsis and infections; pulmonary embolism; complications of spontaneous and induced abortions (including miscarriages, ectopic pregnancies and problems related to unsafe abortions) and anesthetic complications and injuries occurring during delivery.
The findings highlight the need to strengthen key aspects of maternity care, including prenatal services that detect risks early in pregnancy and prevent serious complications; life-saving obstetrics that can manage critical emergencies related to childbirth, such as hemorrhage or embolism; and postnatal care, WHO says.
Most maternal deaths occur during or shortly after childbirth, making this a critical life-saving moment. However, about one-third of women, mainly in low-income countries, still do not receive essential postnatal checkups in the first few days after birth. At the population level, broader preventive interventions could help reduce the prevalence of underlying health conditions, such as noncommunicable diseases and malnutrition, that increase risks for women.
"Often, not just one factor, but many interrelated factors contribute to a woman's death during or after pregnancy; for example, preeclampsia can significantly increase the likelihood of hemorrhage, as well as other complications that can occur even long after delivery," says Dr. Jenny Cresswell, a WHO scientist.
"A more holistic approach to maternal health has been shown to give women the best chance of having a healthy pregnancy and delivery, and enjoying a lasting quality of life after childbirth; health systems should be able to support them through the different stages of life," she assesses.
The study is based on national data reported to WHO, as well as peer-reviewed studies. For some causes, data remain limited. In particular, the authors call for more data on maternal suicide, which is currently only available for 12 countries. In addition, most countries do not report on late maternal deaths (those occurring in the year after childbirth), although several conditions can generate risks that last well beyond the birth itself. After childbirth, many women have difficulty accessing follow-up care, including mental health support. including mental health support.
In light of this problem, WHO is working to strengthen access to high-quality and dignified services throughout the entire pregnancy care process. pregnancy, childbirth and postpartum through evidence-based research and guidelines. In 2024, WHO and its partners launched a Global Roadmap for Postpartum Hemorrhage, outlining key priorities to address this major cause of maternal death. outlining key priorities for addressing this major cause of maternal death.
In the same year, the 194 countries at the World Health Assembly adopted a Resolution committing to strengthen quality care before, during and after childbirth. To spur action, World Health Day 2025 (which marks the fifth anniversary of the Sustainable Development Goals deadline) will focus on maternal and newborn health.
The campaign will call for intensified efforts to ensure access to high-quality, proven care for women and babies, especially in the poorest countries and in crisis situations, where the vast majority of deaths occur. Beyond survival, the campaign will also highlight the need for broader attention to women's health, including postnatal care and support.
About
The study "Global and regional causes of maternal deaths 2009-2020: a WHO systematic analysis" updates a previous analysis conducted in 2014 that covered the period 2003-2009. Hemorrhage was also responsible for the highest proportion of deaths in the previous analysis (27%).
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