GBD 2023: Maternal Deaths Decline Overall But Progress Has Slowed

The GBD 2023 maternal mortality estimates describes a multi-decade global decline in maternal mortality alongside a more recent slowdown and marked geographic unevenness.

The Global Burden of Disease 2023 analysis reports that the global maternal mortality ratio fell from 321 maternal deaths per 100,000 live births in 1990 to approximately 197 in 2023. It also emphasizes that progress has not been uniform across countries and that momentum has weakened in recent years. Overall, it frames the current landscape as long-run improvement with persistent concentration of burden and a deceleration in gains.

For 2023, the research reports an estimated approximately 260,000 maternal deaths worldwide, accounting for a share of deaths among women of reproductive age. It attributes these figures to a GBD 2023 assessment spanning 204 countries and territories through 2023. These estimates are part of an effort to track maternal mortality trends across settings over time. At the same time, it underscores that substantial mortality persists despite the net decline.

The report describes a shift in the pace of improvement: average declines in maternal mortality ratios were nearly 3% per year between 2000 and 2015, compared with about 0.5% per year since 2015. It also notes that some countries experienced increases over the more recent period. Maternal deaths are reported as concentrated in sub-Saharan Africa, Oceania, South Asia, Southeast Asia, and parts of the Caribbean; the summary lists countries such as Nigeria, India, the Democratic Republic of the Congo, Ethiopia, and Pakistan as recording the highest numbers of maternal deaths in 2023. For the highest maternal mortality ratios, it names countries such as Liberia, the Central African Republic, Haiti, Eritrea, and Sierra Leone, underscoring uneven distribution across regions and country groupings.

Cause patterns highlighted include maternal hemorrhage and hypertensive disorders of pregnancy, which it describes as among the leading causes of deaths globally and as largely preventable. Alongside these causes, the research links persistent mortality to health-system and service gaps, including access to antenatal care, safe delivery services, emergency obstetric care, post-partum follow-up, and stronger vital registration and maternal death surveillance. It states that strengthening access to quality maternity care is needed to reverse the slowdown in progress, and that improvements in antenatal care, safe delivery, emergency obstetric care, and post-partum follow-up could substantially reduce mortality. In the report, leading causes and service-access themes are closely connected features of the reported burden.

It also notes a pandemic-related signal in 2020–2021, stating that COVID-19 infection contributed to temporary increases in maternal mortality in several regions, including parts of Latin America and the Caribbean, Central and Eastern Europe, Central Asia, and high-income North America. It adds that in most places with data available through 2022–2023, maternal mortality returned toward pre-pandemic trends, while noting variability in resilience and vulnerability across settings. It also describes expanded evidence inputs for the GBD 2023 analysis, including more than 1,000 newly available data sources and subnational estimates for multiple countries, while characterizing many high-burden regions as data-sparse and highlighting calls to expand vital registration, maternal death surveillance, and local data systems. As illustrative examples, it cites Ethiopia, Bangladesh, Nepal, and Cambodia in connection with reported reductions in maternal deaths alongside expanded facility-based delivery and strengthened maternal health services.

Key Takeaways:

• Recent research describes a decades-long global decline in maternal mortality, alongside a reported slowdown in progress after 2015.
• Maternal mortality is reported as geographically concentrated, with the summary distinguishing countries with the highest numbers of deaths from those with the highest ratios.
• The report highlights hemorrhage and hypertensive disorders among leading causes; it also links persistent mortality to gaps in access to key maternity services and stronger maternal death surveillance, and notes that many high-burden settings remain data-sparse while the analysis includes subnational estimates for multiple countries.