Risk of Death in Childbearing

A woman’s “lifetime risk” of dying in pregnancy or childbirth (LTR) is determined by both the risk of dying during a given pregnancy, and the frequency of exposure to that risk. For this reason, the Reproductive Risk Index includes both the maternal mortality ratio (maternal deaths per 100,000 live births) and total fertility rate (average number of live births per woman) as indicators. In countries such as Ethiopia, Sierra Leone and Burundi, where high fertility is coupled with high maternal mortality, women face an extremely high lifetime risk of dying in pregnancy or childbirth. In Spain and Canada, with low fertility and maternal mortality, women have a low lifetime risk (see table below).

Every pregnancy entails risk, especially where health care is poor. Each year, more than 500,000 women worldwide die from pregnancy or childbirth-related causes, almost all of them in the developing world. The number of deaths is a dramatic figure; yet one study estimated that for every death during pregnancy and childbirth in the developing world there are 16.5 cases of significant maternal illness or disability.

While maternal mortality measures the risk of death from pregnancy and childbirth, it also reflects the general health, social and economic status of women and their access to health care. Maternal deaths result directly from poor health, poor nutrition before and during pregnancy, inadequate care during pregnancy and delivery, and unsafe abortion.Of all development indicators, maternal mortality illustrates most starkly the gaping chasm in well-being between the developed and developing worlds. A woman in a developing country has a one in 60 chance of dying in pregnancy or childbirth, compared with just one in 2,100 in developed countries.

Most maternal deaths could be prevented with inexpensive measures. The World Bank and World Health Organization estimate it would cost just US $3.00 per capita per year to provide standard mother and baby care for women in low-income countries. This care would include prenatal, delivery and postnatal care, as well as postpartum family planning, newborn care, and promotion of condoms to prevent sexually transmitted infections.

Lifetime Risk

Chance of a woman dying from complications of pregnancy, childbirth, or unsafe abortion during her lifetime:

Selected Countries
Ethiopia	1 in 7
India	1 in 57
Brazil	1 in 128
United States of America	1 in 3,418
Spain	1 in 9,058

Regions
Africa	1 in 15
Asia	1 in 105
Latin America and the Caribbean	1 in 150
Europe	1 in 1,895
Northern America	1 in 3,750

Worldwide
World	1 in 70
Developing Countries	1 in 65
Developed Countries	1 in 2,125