Where are women most at risk of dying in childbirth?

The risk of a woman dying in childbirth has declined significantly across the world, yet inequality in health remains large across countries, and in some regions childbirth still comes with a high risk for both the mother and newborn.

Where are women most at risk of dying in childbirth today?

Here there are two metrics we need to distinguish: the maternal risk per pregnancy, but also the lifetime risk to a woman, which depends on the number of children she has.

Mortality risk per pregnancy

In the visualization we see the latest maternal mortality rates across the world. What becomes clear from the map scale – spanning orders of magnitude – is the extent of cross-country inequality: the magnitude of the differences in mortality between countries are very large. In most high-income countries, maternal mortality is now very low. The average rate in the European Union is 8 maternal deaths per 100,000 live births. In some countries such as Poland, Italy, and Sweden, the rate is even lower at 3 to 4 per 100,000.

In Sierra Leone a woman is 300 to 400 times more likely to die with each pregnancy. At an estimated rate of 1120 deaths per 100,000 live births, around 1-in-80 pregnancies ends in the death of the mother.

The five countries where a woman is most likely to die in a given pregnancy are:

  1. South Sudan;
  2. Chad;
  3. Sierra Leone;
  4. Nigeria;
  5. and Somalia.

Share of women that are expected to die from pregnancy or childbirth

Of course, the chances that a woman dies from maternal causes are not only dependent on the risk per pregnancy – which we looked at above – but also the number of pregnancies she has.

The average woman in the UK or Sweden has one or two children. In Niger, she has seven children. Not only is the risk per pregnancy higher at lower incomes, but also the number of births. Maternal mortality rates tend to be higher where women have more children. These amplify the differences in risk between high and low-income countries.

In the visualization we see estimates of the share of women that will die from maternal causes in their lifetime, for the country averages. This is based on the probability that a 15-year-old female dies from pregnancy-related causes if fertility and maternal mortality risks stay constant at their current levels.

Across most of the world, the risk is less than 1%. In most countries, it’s even well below 0.1%.

But, in Sierra Leone, 5% of 15-year-old women today will die from maternal causes sometime in the future, if fertility and maternal mortality rates stay the same. The Democratic Republic of Congo, Chad, Nigeria, Niger and Somalia it’s also over 4%. That’s around every 20th woman.