The World Health Organization (WHO) defines maternal death as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.”
About 73% of all maternal deaths are due to direct obstetric causes; the main killers are severe bleeding, especially postpartum hemorrhage; high blood pressure during pregnancy, which can be caused by pre-eclampsia/eclampsia; and infections, including sepsis.
Complications during child birth and unsafe abortions accounted for smaller but significant percentages of death. Indirect causes (including HIV and other pre-existing medical conditions) account for 27% of maternal deaths.
Three-quarters of all newborn deaths—deaths during the first 28 days of life—occur in the first week of life. The three major causes include preterm birth complications (35%); events during birth (24%), especially low levels of oxygen due to problems with the placenta, obstructed labor or pre-eclampsia/eclampsia; and sepsis or meningitis (15%). In many countries, deaths in children under 5 are decreasing but newborn deaths are not. In some countries, newborn deaths account for up to half of deaths of children under 5 years.
WHO estimates that more than 80% of newborn deaths could be prevented with basic solutions.
According to UNICEF, undernutrition contributes to nearly half of deaths in children under 5. The other main killers are pneumonia, diarrhea and malaria.
Increasing access to affordable health care and improving the quality of care are critical for reducing maternal, newborn and child deaths. This requires well-functioning health facilities; sufficient numbers of doctors, nurses and midwives who are competent in managing complications during pregnancy, childbirth and the postpartum period; adequate supplies of lifesaving drugs—including a range of medications to address severe bleeding after childbirth, magnesium sulfate for severe pre-eclampsia/eclampsia and antibiotics for women and newborns—and equipment, such as Ambu bags for resuscitating newborns who do not breathe at birth; and the ability to access and receive quality care, including at facilities that are equipped and prepared to provide more complex treatments.
Strategies to reduce deaths in children under 5 also include access to quality health care, with a focus on breastfeeding, immunizations, inexpensive medicines such as antimalarial drugs, and clean water and sanitation.
The use of contraception allows families to plan the number and spacing of their children. WHO recommends that after giving birth, women wait at least 24 months before beginning their next pregnancy to reduce risks for themselves and their babies.
For women, short birth intervals increase the risk of nutritional deficiencies, preterm births, giving birth to low-birthweight or small-for-gestational-age babies and even death. For newborns, short interval—less than 18 months—significantly increase the chance of dying. One study in Nairobi showed “that children born within 18 months of an elder sibling are more than twice as likely to die as those born after an interval of 36 months or more.”
Because family planning saves lives, it is estimated that there would be 76,000 fewer maternal deaths each year if the needs for modern contraception were met.