A woman died from pregnancy or childbirth roughly every two minutes in 2023. That works out to 712 deaths a day and about 260,000 for the year, according to the latest joint estimates from the World Health Organization, UNICEF, UNFPA, the World Bank Group and the UN Population Division. The number sounds almost unimaginable next to another fact from the same dataset: in South Sudan, Chad and Nigeria, a woman’s lifetime risk of dying from a pregnancy-related cause is measured in tens, not thousands. In Australia, New Zealand and most of Western Europe, that risk is measured in the tens of thousands.
This is not primarily a story about medicine. Hemorrhage, sepsis and hypertensive disorders are treatable conditions with well-established clinical protocols. What separates a maternal death from a survived complication is almost always distance from a blood transfusion, a functioning operating theater, or a health worker trained to recognize danger in time. The following data maps where that gap is widest, how it has narrowed since 2000, and why raw country rankings can mislead as easily as they inform.
What Global Maternal Mortality Measures
A maternal death is defined by WHO as the death of a woman while pregnant or within 42 days of the end of a pregnancy, from any cause related to or aggravated by the pregnancy or its management, excluding accidental or incidental causes. That definition matters because it draws a line between deaths medically connected to pregnancy and deaths that merely happen to occur during it, such as a road accident.
Two related but distinct figures get used, often interchangeably, in ways that confuse comparisons:
- Maternal deaths is the absolute count of women who died. It is driven heavily by the size of a country’s population and its number of births, which is why Nigeria and India post large totals even where their ratios are improving.
- Maternal mortality ratio (MMR) is the number of maternal deaths per 100,000 live births. Because it is standardized against births rather than total population, MMR is the correct figure for comparing risk across countries of very different sizes.
A third measure, lifetime risk of maternal death, factors in how many times a woman is likely to become pregnant over her life. It captures cumulative exposure to risk in a way a single-pregnancy ratio cannot, which is why it produces some of the starkest global contrasts.
Because civil registration and vital statistics systems are incomplete or absent in many high-burden countries, the headline numbers are modeled estimates, not direct counts. The UN Maternal Mortality Estimation Inter-Agency Group (MMEIG) publishes each estimate with an 80% uncertainty interval; the 2023 global MMR of 197 carries a range of 174 to 234. That range should be kept in mind whenever a specific country figure is quoted as though it were a precise census tally.
The Current Global Maternal Mortality Picture
The latest inter-agency report, Trends in Maternal Mortality 2000 to 2023, released by WHO in 2025, is the authoritative global reference. Its headline figures:
- Global MMR, 2023: 197 maternal deaths per 100,000 live births
- Total maternal deaths, 2023: approximately 260,000
- Daily toll: roughly 712 deaths, or one every two minutes
- Change since 2000: MMR fell 40%, from 328 to 197 per 100,000 live births
- Average annual rate of reduction, 2000 to 2023: 2.2%
That 40% decline understates how uneven progress has been within the period. Reduction was fastest between 2000 and 2015, the era of the Millennium Development Goals’ maternal health target. From 2016 onward, the global rate of decline flattened, and the report explicitly describes progress after 2015 as stagnant when averaged across those eight years.
The COVID-19 pandemic interrupted the trend outright: the report’s first global accounting of pandemic-era maternal survival estimates roughly 40,000 additional maternal deaths in 2021 alone, tied to disrupted health services and reduced access to care during acute waves of infection.
Geographically, the burden is not spread anywhere close to evenly. Sub-Saharan Africa, home to about 15% of the world’s population, accounted for approximately 70% of all maternal deaths in 2023, or roughly 182,000 women. Central and Southern Asia, a far more populous region, accounted for nearly 17% of the global total, or about 44,000 deaths. Eastern and South-Eastern Asia recorded about 13,000 deaths, and North Africa and Western Asia roughly 9,100.
Maternal Deaths by Region, 2023
| Region | Estimated Maternal Deaths | Share of Global Total |
|---|---|---|
| Sub-Saharan Africa | ~182,000 | ~70% |
| Central and Southern Asia | ~44,000 | ~17% |
| Eastern and South-Eastern Asia | ~13,000 | ~5% |
| North Africa and Western Asia | ~9,100 | ~3.5% |
| Latin America and the Caribbean | lower burden, MMR above high-income average | — |
| Europe and Northern America | lowest regional burden | — |
Source: WHO/UNICEF/UNFPA/World Bank Group/UNDESA, Trends in Maternal Mortality 2000-2023.
Where Maternal Mortality Is Highest
Country-level rankings shift depending on the reference year and dataset, and figures for the highest-burden countries carry the widest uncertainty intervals of any in the dataset, since several rely on household surveys rather than complete civil registration. With that caveat, the same handful of countries appear at the top of every recent round of estimates.
South Sudan, Chad and Nigeria have consistently posted the world’s highest maternal mortality ratios. Analysis of the 2023 inter-agency data, echoed by Statista’s compilation of CIA World Factbook figures, puts Nigeria’s MMR at 993 per 100,000 live births, the highest of any large country, with Chad at 748 and South Sudan and the Central African Republic each around 692.
Because Nigeria’s population is far larger than South Sudan’s, its absolute death toll is enormous even at a somewhat lower ratio than some smaller high-burden states: the country alone accounted for close to 75,000 maternal deaths in 2023, nearly 29% of the entire global total, according to UN-agency figures reported around the release of the 2025 report.
Countries With the Highest Maternal Mortality Ratios, 2023
| Rank | Country | MMR (per 100,000 live births) |
|---|---|---|
| 1 | Nigeria | 993 |
| 2 | Chad | 748 |
| 3 | South Sudan | 692 |
| 3 | Central African Republic | 692 |
| 5 | Guinea-Bissau | ~725 (varies by dataset) |
Note: rankings vary slightly by source and reference year because of differing statistical models applied to incomplete underlying data. Figures above reflect 2023 inter-agency and CIA World Factbook-derived estimates; some earlier compilations citing 2020 data place South Sudan above 1,200, illustrating how much modeled estimates can shift between rounds.
Nine sub-Saharan African countries were classified in the 2025 report as having a “very high” maternal mortality ratio, and the region’s dominance of the highest-risk category has a common thread: conflict. In 2023, 37 countries were classified as being in conflict or affected by institutional and social fragility.
Those 37 countries accounted for 61% of all global maternal deaths while containing only 25% of the world’s live births. The MMR in conflict-affected settings was 504 per 100,000 live births, more than five times the rate of 99 recorded in non-conflict, non-fragile settings, and well above the 368 recorded in fragile-but-not-actively-conflict settings.
Where Mothers Face the Lowest Risks
At the opposite end of the distribution, a cluster of mostly European countries report maternal mortality ratios so low that a single additional death in a given year can move the national rate. Belarus, Poland and Norway all report fewer than two deaths per 100,000 live births.
Norway recorded zero recorded maternal deaths in one recent year of Commonwealth Fund comparative data. A second tier of countries, including Spain, Australia, Czechia, Israel, North Macedonia, Malta, Iceland and Seychelles, cluster around three deaths per 100,000.
Within Africa itself, the range is instructive: Seychelles matches the Australia and New Zealand regional average of 3 per 100,000, while Cabo Verde (around 42), Algeria (around 78) and Mauritius (around 84) sit far below the continental average despite the region’s overall burden. That spread demonstrates that geography alone does not determine outcomes; health system investment does.
Countries With the Lowest Maternal Mortality Ratios
| Country | MMR (per 100,000 live births) |
|---|---|
| Belarus | <2 |
| Poland | <2 |
| Norway | <2 |
| Spain, Australia, Czechia, Israel, North Macedonia, Malta, Iceland, Seychelles | ~3 |
The United States is a documented outlier among wealthy nations. A 2024 Commonwealth Fund comparison using 2022 data put the US maternal mortality rate at approximately 22 per 100,000 live births, the highest among the 17 high-income countries in its comparison, and roughly seven to ten times the rate in the Nordic countries and Switzerland. Within the US, Black women face a maternal mortality rate more than double the national average, a disparity the report attributes to unequal access to quality care rather than any biological difference in risk.
What distinguishes low-mortality countries is not simply wealth but continuity and speed of care: near-universal antenatal visits, a skilled attendant (physician, nurse or midwife) present at essentially every birth, and an emergency referral system that can move a hemorrhaging patient to blood products and surgery within an hour, the window in which most direct obstetric deaths become preventable.
Why Maternal Mortality Differs So Dramatically
Global data separates two layers of causation: the immediate clinical event and the structural conditions that determine whether it becomes fatal.
Direct medical causes account for the large majority of maternal deaths worldwide and include:
- Severe bleeding (postpartum hemorrhage), the single leading direct cause globally
- Hypertensive disorders of pregnancy, including pre-eclampsia and eclampsia
- Sepsis and other infections following delivery
- Complications from unsafe abortion, concentrated heavily in countries where safe abortion access is legally or practically restricted
- Obstructed or prolonged labor, often compounded by adolescent pregnancy and small pelvic size in very young mothers
- Underlying conditions such as anemia, malaria and HIV, which increase risk during pregnancy and childbirth even when not classified as the direct cause of death
Structural and access factors determine whether these medical events are survivable:
- Distance to a facility capable of emergency obstetric care, and the availability of transport to reach it
- Presence of a skilled birth attendant and availability of blood, oxytocics and antibiotics on site
- Functioning referral pathways between community-level care and hospitals
- Poverty and the direct or indirect cost of accessing care
- Conflict and displacement, which destroy health infrastructure and supply chains and were associated with an MMR more than five times higher than non-conflict settings in 2023
- Education, which correlates strongly with earlier and more consistent use of antenatal services, though correlation here should not be read as sole causation
Maternal Mortality by Region
| Region | Approx. MMR, 2023 (per 100,000 live births) |
|---|---|
| Sub-Saharan Africa | 454 |
| Central and Southern Asia | well below Sub-Saharan Africa, still above global average |
| Latin America and the Caribbean | moderate, above high-income average |
| Eastern and South-Eastern Asia | low, close to global average or below |
| Europe and Northern America | very low, single digits in most countries |
| Australia and New Zealand | 3 |
Lifetime risk figures make the regional gap even starker than the ratios alone. In 2023, the lifetime risk of maternal death for a woman in a low-income country was about 1 in 66. In high-income countries it was roughly 1 in 8,000.
Sub-Saharan Africa’s lifetime risk of 1 in 55 was about 250 times higher than the 1 in 14,000 recorded for Western Europe, meaning a woman’s cumulative chance of eventually dying from pregnancy-related causes over her reproductive years, not just in a single pregnancy, is two and a half orders of magnitude apart between the two settings.
How Maternal Mortality Has Changed Over Time
The 23-year arc from 2000 to 2023 shows genuine, if incomplete, progress:
Global Maternal Deaths and MMR, Selected Years
| Year | Estimated Maternal Deaths | Global MMR (per 100,000 live births) |
|---|---|---|
| 2000 | ~446,000 | 328 |
| 2015 | ~303,000 | not directly comparable across revisions but markedly lower than 2000 |
| 2023 | ~260,000 | 197 |
The pace of decline was not constant. Reduction was strongest through 2015, the deadline year for the Millennium Development Goals. Since 2016, the global average annual rate of reduction has slowed sharply, and the 2025 MMEIG report explicitly frames 2016-2023 progress as largely stalled.
Only five regions saw their lifetime risk of maternal death cut by more than half across the full 2000-2023 period: sub-Saharan Africa, Northern Africa and Western Asia, Australia and New Zealand, Eastern and South-Eastern Asia, and Oceania excluding Australia and New Zealand.
Progress specifically slowed in Northern Africa and Western Asia, Eastern and South-Eastern Asia, non-Australia/New Zealand Oceania, Europe and Northern America, and Latin America and the Caribbean in the post-2015 period, according to the UNICEF USA summary of the report’s findings.
At the country level, the report notes MMR reductions since 2000 ranging as high as roughly 95% in the best-performing cases and as low as increases in a minority of countries. Separately, analysis of the 2000-2020 window found the ten countries with the largest percentage reduction in MMR were Belarus, Seychelles, Turkmenistan, Romania, Bhutan, Egypt, Estonia, Laos, Kazakhstan and Mozambique, ranging from a 95.5% cut in Belarus to a 76.1% cut in Mozambique, evidence that steep, sustained improvement is achievable even from a high starting baseline.
Not every trend line points downward. Compared with 2017-era estimates, the maternal mortality ratio rose in 17 countries even as it fell in 30 others, according to WHO African regional office analysis, with Nigeria’s own ratio cited as having increased over parts of the 2010s before recent data suggested renewed decline.
The Role of Healthcare Access
The mechanics of survival during a life-threatening obstetric complication are well understood clinically, and the gap between high- and low-mortality countries maps closely onto access to specific interventions:
- Skilled birth attendance. A trained doctor, nurse or midwife present at delivery is associated with markedly lower mortality, because most fatal complications, hemorrhage above all, can be recognized and treated within the first hour if a trained provider is present with the right supplies.
- Emergency obstetric care. WHO defines a minimum standard of “signal functions” a facility must provide, including administering antibiotics, oxytocics and anticonvulsants, performing manual removal of the placenta, and, at a comprehensive level, performing surgery and blood transfusion. Access to a facility offering these functions within a survivable time window is the single largest structural determinant of maternal survival.
- Antenatal and postnatal care. Regular antenatal visits allow early detection of hypertensive disorders and anemia before they become emergencies; postnatal care catches hemorrhage and sepsis in the days following delivery, when a large share of maternal deaths still occur.
- Blood supply and referral systems. Even where a facility exists, a maternal death can still occur if it lacks blood products or the transport network to move a patient from a community clinic to a hospital capable of surgery.
Maternal Mortality and Inequality
Global averages conceal wide within-country gaps that mirror the between-country ones. Reliable comparable data are more limited at this level, but consistent patterns include:
- Income classification. The MMR in low-income countries as a group stood at 346 per 100,000 live births in 2023, versus 10 per 100,000 in high-income countries, a roughly 35-fold gap.
- Rural versus urban residence. In many high-burden countries, rural populations face longer transport times to emergency obstetric care, though the size of this gap varies substantially by country and is not uniformly documented at the global level.
- Race and ethnicity within wealthy countries. The clearest documented example is the United States, where Black women’s maternal mortality rate is more than double the national average, a disparity researchers link to differential quality of care and structural inequality in the health system rather than any inherent biological difference in obstetric risk.
- Age. Adolescent mothers face elevated obstetric risk, including higher rates of obstructed labor, though global age-disaggregated maternal mortality data remain less complete than overall MMR estimates.
Can Global Maternal Mortality Continue to Fall?
The Sustainable Development Goal target (SDG 3.1) calls for a global MMR below 70 per 100,000 live births by 2030, alongside a supplementary national target that no single country should exceed 140, twice the global goal. Reaching the global target from the 2023 baseline of 197 would require an average annual rate of reduction of almost 15% between 2024 and 2030, roughly seven times faster than the 2.2% average pace achieved across the full 2000-2023 period.
On current trajectories, that target will not be met globally, and WHO has separately warned that more than 60 countries risk missing the related maternal, newborn and stillbirth reduction targets on present trends.
Two forces work in opposing directions. On one hand, expanding skilled birth attendance, emergency obstetric coverage and antenatal care in the highest-burden countries has demonstrably worked before, cutting the global MMR by 40% since 2000.
On the other, the report explicitly flags humanitarian funding cuts as a live threat to essential maternal, newborn and child health services in many countries at the time of its 2025 release, and conflict-driven fragility, already responsible for 61% of global deaths from just 37 countries, shows no sign of receding. Any projection of continued decline should be read as conditional on sustained investment rather than a guaranteed trend.
Data Limitations and How Maternal Mortality Is Estimated
Reported statistics for maternal mortality are, in the majority of high-burden countries, modeled estimates rather than direct counts. Complete civil registration and vital statistics (CRVS) systems, which register nearly all deaths and correctly classify their cause, are rare in the countries where maternal mortality is highest.
In their absence, MMEIG uses statistical modeling that draws on household surveys, censuses, and specialized studies, combined with live birth data from the UN’s World Population Prospects, to generate the proportion of deaths among women of reproductive age attributable to maternal causes, then converts that into an MMR.
Every point estimate MMEIG publishes carries an 80% uncertainty interval. For the 2023 global figure of 197, that interval runs from 174 to 234, meaning there is an 80% statistical probability the true global MMR falls somewhere in that range, and a 90% certainty it is at least 174.
For individual high-burden countries lacking CRVS, these intervals widen considerably, which is why competing rankings of the “worst” countries for maternal mortality can differ by hundreds of points between publications using different reference years or underlying survey data. Readers comparing country rankings across different sources should check whether the figures come from the same MMEIG round and reference year before treating small differences in rank as meaningful.
Conclusion
The 40% decline in global maternal mortality since 2000 is a genuine public health achievement, proof that the specific interventions known to prevent these deaths, skilled birth attendants, emergency obstetric facilities, blood supplies and functioning referral networks, work when they reach the women who need them. What the data makes equally clear is that this progress has essentially stalled since 2015, even as the remaining burden has concentrated ever more tightly into a narrow set of conflict-affected countries in sub-Saharan Africa.
Closing the gap between a lifetime risk of 1 in 55 and 1 in 14,000 was never going to be primarily a medical challenge. It is a question of whether health systems in the highest-risk settings can be built and funded fast enough to reach mothers before the next emergency.
Key Findings
- Global maternal deaths fell from about 446,000 in 2000 to about 260,000 in 2023, a 40% decline in the maternal mortality ratio, but progress has stagnated since 2015.
- Sub-Saharan Africa accounts for about 70% of all global maternal deaths despite holding a much smaller share of the world’s population, driven heavily by conflict, fragile health systems and limited emergency obstetric coverage.
- Nigeria alone accounted for close to 29% of global maternal deaths in 2023, roughly 75,000 women, more than any other single country.
- The lifetime risk of maternal death in sub-Saharan Africa (1 in 55) is roughly 250 times higher than in Western Europe (1 in 14,000).
- Conflict-affected settings recorded an MMR of 504 per 100,000 live births in 2023, more than five times the rate in non-conflict, non-fragile settings.
- The United States has the highest maternal mortality rate among wealthy nations, about 22 per 100,000 live births, more than seven times Norway’s rate in comparable data.
- Reaching the 2030 SDG target of an MMR below 70 would require cutting the global rate nearly seven times faster than the average pace achieved since 2000.
Frequently Asked Questions
1. Which country has the highest maternal mortality rate?
Based on 2023 inter-agency estimates, Nigeria has the highest maternal mortality ratio among large countries at around 993 deaths per 100,000 live births, with Chad, South Sudan and the Central African Republic close behind. Exact rankings shift between data rounds because of wide uncertainty intervals in countries lacking complete death registration.
2. How many women die from maternal causes worldwide each year?
An estimated 260,000 women died from pregnancy or childbirth-related causes in 2023, according to the WHO-led inter-agency estimate, equivalent to about 712 deaths per day.
3. What causes most maternal deaths?
Severe bleeding (postpartum hemorrhage) is the leading direct medical cause worldwide, followed by hypertensive disorders such as pre-eclampsia, sepsis, complications of unsafe abortion, and obstructed labor. Underlying conditions like anemia and malaria also raise risk.
4. Has global maternal mortality decreased?
Yes. The global maternal mortality ratio fell 40% between 2000 and 2023, from 328 to 197 deaths per 100,000 live births. Most of that decline occurred before 2015; progress has been comparatively stagnant since.
5. Why is maternal mortality higher in some regions?
The gap is driven primarily by access to skilled birth attendants, emergency obstetric care and blood supplies, compounded by conflict, poverty and weak referral systems between community clinics and hospitals. Sub-Saharan Africa, which holds a disproportionate share of countries affected by conflict and fragility, accounts for about 70% of global maternal deaths.
6. Which countries have the lowest maternal mortality?
Belarus, Poland and Norway report fewer than two maternal deaths per 100,000 live births, among the lowest recorded rates globally, alongside Spain, Australia, Czechia, Israel and several other high-income countries at around three per 100,000.
7. Is maternal mortality only a problem in low-income countries?
No. While over 90% of maternal deaths occur in low- and lower-middle-income countries, the United States has the highest maternal mortality rate among wealthy nations at roughly 22 per 100,000 live births, with a documented racial disparity in which Black women face more than double the national average risk.
8. What is the difference between maternal mortality ratio and maternal death count?
Maternal death count is the absolute number of deaths, driven partly by population and birth volume. Maternal mortality ratio standardizes deaths against every 100,000 live births, making it the correct measure for comparing risk levels across countries of different sizes.
9. How reliable are maternal mortality statistics?
Reliability varies substantially by country. Nations with complete civil registration systems report near-exact figures, while many high-burden countries rely on modeled estimates from household surveys, which come with wide statistical uncertainty intervals, roughly 174 to 234 around the 2023 global point estimate of 197.
10. Can the world still meet its 2030 maternal mortality target?
The Sustainable Development Goal target of an MMR below 70 by 2030 would require an annual rate of reduction of almost 15% from 2024 onward, nearly seven times faster than the 2.2% average pace achieved from 2000 to 2023. On current trends, WHO has indicated more than 60 countries are at risk of missing related 2030 targets.
Sources
- World Health Organization, UNICEF, UNFPA, World Bank Group, UNDESA/Population Division, Trends in Maternal Mortality 2000 to 2023, WHO, Geneva, 2025 (who.int)
- WHO, “Maternal mortality” fact sheet, 7 April 2025 (who.int)
- UNICEF Data, “Maternal mortality rates and statistics” (data.unicef.org)
- UNICEF USA, “Trends in Maternal Mortality Estimates 2000 to 2023” (unicefusa.org)
- Statista, “Maternal mortality rate by country in Africa,” citing CIA World Factbook 2023 data (statista.com)
- WHO Regional Office for Africa, Analytical Fact Sheet, Reproductive and Maternal Health Team, March 2023 (aho.afro.who.int)
- The Commonwealth Fund, international maternal mortality comparison using 2022 data, cited via Statista and AOL News, June 2024
- World Bank Open Data, Maternal mortality ratio (modeled estimate, per 100,000 live births)
