The World Health Organization defines maternal health as the health of women during pregnancy, childbirth, and the postnatal period, with the goal that each stage be a positive experience where women and their babies reach their full potential. In 2023, about 260,000 women died from preventable causes related to pregnancy and childbirth, a rate of more than 700 deaths every day. The WHO sets global standards for care at every stage and tracks progress toward reducing those numbers.
The Scale of Maternal Mortality
A maternal death occurred almost every two minutes in 2023. The global maternal mortality ratio that year was 197 deaths per 100,000 live births. To put that in context, the United Nations Sustainable Development Goal (SDG 3.1) calls for reducing that number to fewer than 70 per 100,000 live births by 2030. As of the most recent data, the world is more than three times above that target.
Between 2015 and 2020, the global ratio dropped by only four points, from 227 to 223. Reaching the 2030 goal would require a 15% annual reduction, a pace that has rarely been achieved even at the national level in any country. Progress has been real over the past two decades, but it has slowed dramatically in recent years.
What Happens During Antenatal Care
The WHO recommends a minimum of eight antenatal care contacts over the course of a pregnancy. This model, introduced in 2016, replaced an earlier four-visit schedule after evidence showed that more frequent contact reduces the risk of stillbirth and improves women’s experience of care. These visits aren’t just checkups. They cover nutrition, screening, prevention, and emotional wellbeing in a structured sequence.
Nutritional support is a core element. The WHO recommends daily iron and folic acid supplements for all pregnant women to prevent anemia, low birth weight, and preterm birth. In populations where dietary calcium is low, daily calcium supplementation is recommended to reduce the risk of pre-eclampsia, a dangerous condition involving high blood pressure. Counseling on healthy eating and physical activity is standard at every visit.
Screening goes beyond physical exams. Providers are expected to ask about tobacco and alcohol use at every visit and to screen for intimate partner violence when conditions allow for a supportive response. At least one ultrasound before 24 weeks is recommended to estimate gestational age, detect fetal anomalies, and identify multiple pregnancies. Tetanus vaccination is recommended at the first contact to protect the newborn.
Care During Labor and Birth
The WHO developed the Labour Care Guide as a tool for supporting evidence-based, respectful care during childbirth regardless of the setting. It’s designed for use in both well-equipped hospitals and lower-resource facilities. The emphasis on “respectful care” is intentional: the WHO frames a positive childbirth experience as a health outcome in itself, not a luxury.
Having a skilled birth attendant present during delivery is considered the single most important strategy for preventing maternal and newborn death. Skilled attendants can manage or prevent most obstetric complications, and the proportion of births attended by trained professionals is one of the primary indicators the WHO uses to track global progress.
Preventing Severe Bleeding After Birth
Postpartum hemorrhage, or severe bleeding after delivery, is one of the leading causes of maternal death worldwide. The WHO developed a protocol called E-MOTIVE that combines early detection with a bundle of first-response treatments. Women are monitored using a calibrated blood-collection drape that measures blood loss in real time rather than relying on visual estimates, which are notoriously inaccurate.
When hemorrhage is detected, the treatment bundle kicks in: uterine massage, medications to help the uterus contract, a drug that helps blood clot, intravenous fluids, and a structured process for further examination. In a large randomized trial published in the New England Journal of Medicine, this approach reduced the rate of severe outcomes to 1.6% of patients, compared with 4.3% under usual care. That’s a 60% reduction, achieved with interventions that are feasible even in lower-resource hospitals.
The First Hours and Days After Birth
The WHO recommends that mothers and newborns who had an uncomplicated vaginal birth in a health facility stay for at least 24 hours before discharge. If the birth takes place at home, the first postnatal contact should happen as early as possible within the first 24 hours. These early hours are a high-risk window for both mother and baby.
During the first 24 hours, the mother’s vaginal bleeding, uterine contraction, temperature, heart rate, and blood pressure should all be monitored at regular intervals, starting within the first hour. Blood pressure is measured shortly after birth and again within six hours. Urination is documented within six hours to confirm normal kidney function.
For the newborn, the WHO recommends an immediate assessment at birth and a full clinical examination around one hour later. Exclusive breastfeeding from birth through six months is a cornerstone recommendation, with counseling and support offered at every postnatal contact. Bathing should be delayed until at least 24 hours after birth to help stabilize the baby’s temperature. Mother and baby should not be separated and should remain in the same room around the clock.
Why the Gap Between Rich and Poor Countries Persists
The vast majority of maternal deaths are concentrated in lower-income countries and regions with limited access to trained health workers, emergency obstetric care, and basic supplies like blood for transfusions. Most of these deaths are preventable with interventions that already exist and are routine in wealthier nations. The gap is not primarily a knowledge gap. It’s a gap in resources, infrastructure, and health workforce distribution.
The WHO identifies several layers of barriers. Geographic distance from facilities, shortage of skilled birth attendants, lack of referral systems for emergencies, and financial costs that prevent women from seeking care all play a role. Social factors compound the problem: in many settings, women’s ability to make decisions about their own care is limited, and adolescent pregnancies carry higher medical risks alongside fewer social supports.
Reaching the SDG target of fewer than 70 maternal deaths per 100,000 live births by 2030 would require not just clinical interventions but systemic changes in how maternal health services are funded, staffed, and delivered. At the current pace of decline, that target will not be met globally, though individual countries have shown it’s achievable with sustained investment. The WHO’s framework treats maternal health not as a clinical challenge alone but as a measure of whether health systems are functioning for the people who need them most.