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Reduce by three-quarters, between 1990 
and 2015, the maternal mortality ratio
 
 
 
Death in childbirth is a rare event in rich countries, where there are typically fewer than 10 maternal deaths for every 100,000 live births. But in the poorest countries of Africa and Asia the ratio may be 100 times higher. And because women in poor countries have more children, their lifetime risk of maternal death may be more than 200 times greater than for women in Western Europe and North America.
 
More than 500,000 women die each year in childbirth, most of them in developing countries. What makes maternal mortality such a compelling problem is that it strikes young women experiencing a natural function of life. They die because they are poor. Malnourished. Weakened by disease. Exposed to multiple pregnancies. And they die because they lack access to trained health care workers and modern medical facilities.
 
 Mothers at risk in Africa and South Asia
 Left axis (line): total fertility rate (births per woman);
 right axis (bar): maternal mortality ratio (deaths per 100,000 live births)
  Sub-Saharan Africa   South Asia
   
 
Maternal mortality ratios are still unacceptably high in many developing countries as a result of high fertility rates and a high risk of dying each time a woman becomes pregnant.
 
  East Asia & Pacific   Latin America & Caribbean
   
 
Some developing countries have substantially improved maternal health through better services in hospitals and increased numbers of trained birth attendants and midwives.
 
  Europe & Central Asia   Middle East & North Africa
   
 
Still others not only improved maternal health, but significantly lowered fertility rates directly through use of contraceptives and indirectly through increased female education.
 
 

Source: World Bank staff estimates.

       
 

    
                 
 Country by country progress in providing skilled care at births
 Share of countries on track to achieve adequate coverage of births by
 skilled health personnel (%)
    

Source: World Bank staff estimates.
     

    
Because few countries are able to measure maternal mortality over time, other indicators are often used to measure progress toward this goal. Skilled health personnel and modern medical facilities are needed to deal with the complications of childbirth that can claim mothers’ lives. This figure shows the proportion of countries in each region that provide skilled health personnel for 90 percent of births or could do so by 2015 based on current trends. Countries that are off track may be able to achieve 75 percent coverage by 2015, while seriously off-track countries will not reach even that level unless they make rapid progress in the next decade.
 
    
 Decreasing risk of young motherhood
 Adolescent fertility rate (births per 1,000 women ages 15– 19)
    

Source: World Bank staff estimates.
     
Fertility rates among young women have been falling, but they remain high in Sub-Saharan Africa, South Asia, and Latin America and the Caribbean. Young mothers run higher risks of complications in childbirth and lower birthweight babies. They are also likely to have more births over their lifetime, increasing their lifetime risk of maternal death. Education and access to reproductive health services help to lower fertility rates.
 

    
 Poor women need reproductive health services
Zimbabwe, 1999
Total fertility rate by wealth quintile (births per woman)
 

In Zimbabwe total fertility rates are high except for women from the highest income group.

      
         
        Zimbabwe, 1999
Contraceptive prevalence rate by wealth quintile (%)
 

Wealthier men and
women are more likely
to use contraception.

    
         
        Zimbabwe, 1999
Source of contraception by wealth quintiles (%)
 

In Zimbabwe both poor and rich rely heavily on public sources for contraception.

    
         
        Contraceptive prevalence rates
Share of women in union (%)
 

Where contraceptive prevalence rates are higher, men and women are more likely to be using modern methods.

    
         

Source: World Bank staff estimates based on Demographic
and Health Surveys; State of the World’s Population 2005.
 
 

         
 Text figures & Boxes
Mothers at risk in Africa and South Asia
 
Sub-Saharan Africa
South Asia
East Asia & Pacific
Latin America & Caribbean
Europe & Central Asia
Middle East & North Africa
   
Country by country progress in providing skilled care at births

         

Decreasing risk of young motherhood

     
Poor women need reproductive health services
 
Zimbabwe, 1999
Total fertility rate by wealth quintile (births per woman)
Zimbabwe, 1999
Contraceptive prevalence rate by wealth quintile (%)
Zimbabwe, 1999
Source of contraception by wealth quintiles (%)
Contraceptive prevalence rates
Share of women in union (%)