Roughly 260,000 women died during or shortly after pregnancy and childbirth in 2023, according to WHO estimates. That works out to more than 700 preventable deaths every day. The global maternal mortality ratio (MMR) stood at 197 deaths per 100,000 live births in 2023, but this number masks enormous differences between countries. A woman giving birth in South Sudan faces a risk hundreds of times greater than a woman in Australia or New Zealand.
Countries With the Highest Maternal Mortality
The countries with the most dangerous pregnancy outcomes are concentrated in sub-Saharan Africa. Based on 2020 WHO estimates, the ten highest maternal mortality ratios in the world are:
- South Sudan: 1,223 per 100,000 live births
- Chad: 1,063 per 100,000
- Nigeria: 1,047 per 100,000
- Central African Republic: 835 per 100,000
- Guinea-Bissau: 725 per 100,000
- Liberia: 652 per 100,000
- Lesotho: 566 per 100,000
- Guinea: 553 per 100,000
- Democratic Republic of the Congo: 547 per 100,000
- Kenya: 530 per 100,000
In South Sudan, that ratio means roughly 1 in every 82 live births results in the mother’s death. These numbers reflect not just medical challenges but years of conflict, weak health infrastructure, and limited access to trained birth attendants and emergency obstetric care.
Countries With the Lowest Maternal Mortality
At the other end of the spectrum, wealthy nations with strong health systems report maternal mortality ratios in the single digits. In 2023, Australia and New Zealand recorded just 3 maternal deaths per 100,000 live births. Within Africa, Seychelles matched that figure at 3 per 100,000, while Cabo Verde (42), Algeria (78), and Mauritius (84) also stood far below the continental average.
Most of Western Europe, East Asia, and the Gulf states report MMRs below 10, though exact figures vary by reporting year. These countries share common features: universal or near-universal access to prenatal care, skilled birth attendants at virtually every delivery, and functioning emergency referral systems for complications.
The United States Compared to Peer Nations
The United States is a notable outlier among high-income countries. In 2020, its maternal mortality rate was 23.8 deaths per 100,000 live births, up from 20.1 in 2019. That figure is several times higher than in most other wealthy nations, where ratios typically fall between 2 and 10. Racial disparities within the U.S. widen the gap further, with Black women dying at significantly higher rates than white women.
The Regional Gap in Numbers
Sub-Saharan Africa carries a disproportionate share of the global burden. The region’s MMR in 2023 was 454 per 100,000 live births, more than double the global average and roughly 150 times the rate in Australia and New Zealand. This single region accounts for the majority of the world’s maternal deaths despite representing a smaller share of global births.
Progress has been uneven over time. Between 2000 and 2015, the global MMR dropped at an annual rate of about 2.7%. But from 2016 to 2020, that progress stalled almost entirely. The broader trend from 2000 to 2023 shows a 40% decline overall, from 328 to 197 per 100,000, but the slowdown in recent years has raised serious concerns about meeting international targets.
Why Women Die in Pregnancy and Childbirth
The leading cause of maternal death worldwide is severe bleeding, primarily after delivery. Hemorrhage accounts for about 27% of all maternal deaths globally. Hypertensive disorders, including dangerously high blood pressure and a condition called preeclampsia, cause another 16%. Infections, unsafe abortions, and complications from pre-existing conditions like diabetes and heart disease make up much of the remainder.
What makes these numbers tragic is that most of these deaths are preventable with interventions that already exist. Severe bleeding can be managed with medications and blood transfusions. High blood pressure can be detected during routine prenatal visits. Infections respond to antibiotics when caught early. The gap between countries is largely a gap in access to these basic services.
How These Numbers Are Measured
The maternal mortality ratio counts the number of women who die from pregnancy-related causes (during pregnancy or within 42 days of its end) per 100,000 live births. It excludes deaths from accidents or unrelated causes. This is the standard metric used by the WHO and United Nations to compare countries.
In many of the highest-burden countries, these figures come with significant uncertainty. Nations like Afghanistan, Ethiopia, Haiti, Nigeria, and Yemen lack complete death registration systems, so their estimates rely on household surveys rather than direct counts. Different statistical models applied to the same survey data can produce notably different results. For Chad, South Sudan, and the Democratic Republic of the Congo, the numbers represent best estimates rather than precise tallies. This means the true toll could be higher or lower than reported, and changes over time are harder to confirm with confidence.
Global Targets and Where Things Stand
The United Nations Sustainable Development Goals set a target of reducing the global MMR to fewer than 70 deaths per 100,000 live births by 2030. At the current rate of 197 per 100,000, the world is not on track. Reaching that goal would require a pace of decline far faster than anything achieved in the past two decades.
The WHO is working with 55 countries through its Every Woman Every Newborn Everywhere initiative to expand access to emergency obstetric care, family planning, and skilled birth attendants. In conflict zones like Sudan and Syria, mobile clinics and temporary health posts provide prenatal screenings and emergency services where hospitals have been destroyed or overwhelmed. New clinical guidance on managing postpartum hemorrhage is expected soon, targeting the single largest killer of mothers worldwide.
Beyond emergency care, the focus is widening to include conditions that complicate pregnancy indirectly: mental health, malnutrition, and chronic diseases like diabetes and hypertension, which are increasingly common even in lower-income countries. Policy measures like paid maternity leave and legal protections for pregnant workers are also part of the broader strategy, recognizing that maternal survival depends on more than what happens in a delivery room.