Severe bleeding and high blood pressure-related disorders such as preeclampsia are the top causes of maternal deaths worldwide, accounting for around 80,000 and 50,000 deaths, respectively, in 2020.

These numbers show that many women still lack access to lifesaving treatments and effective healthcare before, during, and after pregnancy and childbirth.

A new study from the World Health Organization (WHO), titled ‘Global and Regional Causes of Maternal Deaths 2009–2020: A WHO Systematic Analysis,’ published in The Lancet Global Health, reveals that nearly a quarter (23%) of maternal deaths during pregnancy and childbirth are linked to various health conditions, including both infectious diseases such as HIV/AIDS and malaria, as well as chronic conditions like anemia and diabetes.

The study estimates that there were 287,000 maternal deaths in total in 2020, which averages to one death every two minutes.

It reports that hemorrhage, mostly occurring during or after childbirth, accounts for nearly a third (27%) of maternal deaths, while preeclampsia and other hypertensive disorders contribute an additional 16%.

Preeclampsia, a severe condition marked by high blood pressure, can lead to complications such as hemorrhage, strokes, organ failure, and seizures if not treated promptly or effectively.

Other direct causes include sepsis and infections, pulmonary embolism, complications arising from spontaneous and induced abortions—such as miscarriage, ectopic pregnancies, and problems related to unsafe abortions—along with anesthetic complications and injuries during childbirth.

The study highlights that these conditions, which frequently remain undiagnosed or untreated until serious complications arise, increase the risks and complicate pregnancies for millions of women globally.

A Scientist at WHO and an author of the paper, Dr. Jenny Cresswell, states that it is often not just one, but multiple interrelated factors that contribute to a woman’s death during or after pregnancy.

For example, preeclampsia can significantly raise the likelihood of hemorrhage, as well as other complications that may persist long after childbirth.

 “A more holistic approach to maternal health has been proven to give women the best chance of a healthy pregnancy and birth, and of enjoying lasting quality of life after delivery – health systems need to be able to support them across different life stages.” 

Experts argue that the findings emphasize the need to enhance key aspects of maternity care, such as antenatal services that identify risks early in pregnancy and prevent severe complications, life-saving obstetric care that can address critical birth-related emergencies like hemorrhage or embolism, and postnatal care. Since most maternal deaths occur during or shortly after childbirth, this period is crucial for saving lives.

Director of Sexual and Reproductive Health and Research at WHO and the UN’s Special Programme on Human Reproduction (HRP), Dr. Pascale Allotey, stated that understanding the reasons behind maternal deaths is essential for addressing the ongoing global maternal mortality crisis and ensuring that women have the best possible chances of surviving childbirth.

“This is also a massive equity issue globally - women everywhere need high quality, evidence-based health care before, during and after delivery, as well as efforts to prevent and treat other underlying conditions that jeopardize their health.”

The study marks the first global update by the WHO on the causes of maternal deaths since the adoption of the United Nations' Sustainable Development Goals in 2015.

It draws on national data that is reported to WHO, as well as peer-reviewed studies.