The Problem

Every two minutes, a woman dies in childbirth.

And in sub-Saharan Africa, women are 136 times more likely to die than in developed countries.  We also know that healthy mothers help raise healthy children who get better food and more time in school – leading to stronger families, communities and nations.

The onset of labor marks the start of a high-risk period for both mother and baby that does not ease until at least 48 hours after birth. During this short period of time, 145,000 maternal deaths, 1.45 million neonatal deaths, and 1.2 million stillbirths occur each year.

  • For the mother, the risk factors occurring during pregnancy and after labor include hemorrhage, hypertensive disorders, serious infections, and obstructed labor.
  • For the newborn, the critical conditions occurring after birth are serious infections (sepsis, meningitis, pneumonia, and diarrhea), intrapartum-related deaths (“birth asphyxia”), and complications of preterm birth.
  • Important causes of stillbirth include birth asphyxia, maternal and antepartum hemorrhage, fetal bacterial infection, obstructed labor, syphilis and malaria.
  • Important causes of maternal and newborn/infant complications result from next births that are spaced too closely.

Almost all of the deaths during this high-risk period occur in low- and middle-income countries, especially in sub-Saharan Africa and South Asia, where access to quality care is also the poorest. In addition, the absence or dearth of electricity, clean water, adequate transportation, trained health professionals are also factors, in addition to cultures, traditions, and beliefs which may also prevent women from seeking and receiving life-saving care at the time of birth.

We have many powerful tools such as skilled attendance at delivery; emergency obstetric and newborn care; parenteral administration of drugs; blood transfusions; kangaroo care for newborns; early initiation of breastfeeding; hygiene; and rapid diagnosis and early treatment of infections. However, these interventions are not always available to the women and children who need them.

Since many opportunities to optimize birth outcomes occur before and after the time of birth, it is also important to improve access to prenatal care, family planning resources, birth spacing and delay, proper nutrition, and post and antenatal care.

Taken together, these limitations leave poor, rural women—who have the greatest geographical and financial challenges in securing the care of skilled birth attendants—and their babies at the highest risk of poor pregnancy outcomes.