This data presents national-level provisional maternal mortality rates based on a current flow of mortality and natality data in the National Vital Statistics System. Provisional rates which are an early estimate of the number of maternal deaths per 100,000 live births, are shown as of the date specified and may not include all deaths and births that occurred during a given time period (see Technical Notes). A maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. In this data visualization, maternal deaths are those deaths with an underlying cause of death assigned to International Statistical Classification of Diseases, 10th Revision (ICD-10) code numbers A34, O00–O95, and O98–O99. The provisional data include reported 12 month-ending provisional maternal mortality rates overall, by age, and by race and Hispanic origin. Provisional maternal mortality rates presented in this data visualization are for “12-month ending periods,” defined as the number of maternal deaths per 100,000 live births occurring in the 12-month period ending in the month indicated. For example, the 12-month ending period in June 2020 would include deaths and births occurring from July 1, 2019, through June 30, 2020. Evaluation of trends over time should compare estimates from year to year (June 2020 and June 2021), rather than month to month, to avoid overlapping time periods. In the visualization and in the accompanying data file, rates based on death counts less than 20 are suppressed in accordance with current NCHS standards of reliability for rates. Death counts between 1-9 in the data file are suppressed in accordance with National Center for Health Statistics (NCHS) confidentiality standards. Provisional data presented on this page will be updated on a quarterly basis as additional records are received. Previously released estimates are revised to include data and record updates received since the previous release. As a result, the reliability of estimates for a 12-month period ending with a specific month will improve with each quarterly release and estimates for previous time periods may change as new data and updates are received.

Data source: Nepal Demographic and Health Surveys 1996 and 2006.aTiming of the estimates is 3.5 years prior to the dates of the surveys.*Denotes statistical significance of difference at less than 5%.

This report presents maternal mortality rates for 2020 based on data from the National Vital Statistics System. A maternal death is defined by the World Health Organization as, “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes” (1). Maternal mortality rates, which are the number of maternal deaths per 100,000 live births, are shown in this report by age group and race and Hispanic origin.

Cuba CU: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data was reported at 38.000 Ratio in 2017. This records a decrease from the previous number of 41.000 Ratio for 2016. Cuba CU: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data is updated yearly, averaging 42.000 Ratio from Dec 1985 (Median) to 2017, with 33 observations. The data reached an all-time high of 53.000 Ratio in 1994 and a record low of 28.000 Ratio in 2007. Cuba CU: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Cuba – Table CU.World Bank.WDI: Social: Health Statistics. Maternal mortality ratio is the number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births.;The country data compiled, adjusted and used in the estimation model by the Maternal Mortality Estimation Inter-Agency Group (MMEIG). The country data were compiled from the following sources: civil registration and vital statistics; specialized studies on maternal mortality; population based surveys and censuses; other available data sources including data from surveillance sites.;;

Jordan JO: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data was reported at 19.000 Ratio in 2009. This records a decrease from the previous number of 36.000 Ratio for 1997. Jordan JO: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data is updated yearly, averaging 36.000 Ratio from Dec 1996 (Median) to 2009, with 3 observations. The data reached an all-time high of 41.000 Ratio in 1996 and a record low of 19.000 Ratio in 2009. Jordan JO: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Jordan – Table JO.World Bank: Health Statistics. Maternal mortality ratio is the number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births.; ; UNICEF, State of the World's Children, Childinfo, and Demographic and Health Surveys.; ;

Mexico MX: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data was reported at 38.200 Ratio in 2013. This records a decrease from the previous number of 42.300 Ratio for 2012. Mexico MX: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data is updated yearly, averaging 53.550 Ratio from Dec 2004 (Median) to 2013, with 8 observations. The data reached an all-time high of 63.300 Ratio in 2009 and a record low of 38.200 Ratio in 2013. Mexico MX: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Mexico – Table MX.World Bank.WDI: Health Statistics. Maternal mortality ratio is the number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births.; ; UNICEF, State of the World's Children, Childinfo, and Demographic and Health Surveys.; ;

Maternal mortality rates can vary significantly around the world. For example, in 2022, Estonia had a maternal mortality rate of zero per 100,000 live births, while Mexico reported a rate of 38 deaths per 100,000 live births. However, the regions with the highest number of maternal deaths are Sub-Saharan Africa and Southern Asia, with differences between countries and regions often reflecting inequalities in health care services and access. Most causes of maternal mortality are preventable and treatable with the most common causes including severe bleeding, infections, complications during delivery, high blood pressure during pregnancy, and unsafe abortion. Maternal mortality in the United States In 2022, there were a total of 817 maternal deaths in the United States. Women aged 25 to 39 years accounted for 578 of these deaths, however, rates of maternal mortality are much higher among women aged 40 years and older. In 2022, the rate of maternal mortality among women aged 40 years and older in the U.S. was 87 per 100,000 live births, compared to a rate of 21 among women aged 25 to 39 years. The rate of maternal mortality in the U.S. has risen in recent years among all age groups. Differences in maternal mortality in the U.S. by race/ethnicity Sadly, there are great disparities in maternal mortality in the United States among different races and ethnicities. In 2022, the rate of maternal mortality among non-Hispanic white women was about 19 per 100,000 live births, while non-Hispanic Black women died from maternal causes at a rate of almost 50 per 100,000 live births. Rates of maternal mortality have risen for white and Hispanic women in recent years, but Black women have by far seen the largest increase in maternal mortality. In 2022, around 253 Black women died from maternal causes in the United States.

Costa Rica CR: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data was reported at 24.000 Ratio in 2018. This records a decrease from the previous number of 29.000 Ratio for 2014. Costa Rica CR: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data is updated yearly, averaging 28.500 Ratio from Dec 1985 (Median) to 2018, with 30 observations. The data reached an all-time high of 39.000 Ratio in 2007 and a record low of 14.000 Ratio in 2013. Costa Rica CR: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Costa Rica – Table CR.World Bank.WDI: Social: Health Statistics. Maternal mortality ratio is the number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births.;The country data compiled, adjusted and used in the estimation model by the Maternal Mortality Estimation Inter-Agency Group (MMEIG). The country data were compiled from the following sources: civil registration and vital statistics; specialized studies on maternal mortality; population based surveys and censuses; other available data sources including data from surveillance sites.;;

Sources:a National Institute for Population Research and Training, MEASURE Evaluation, International Centre for Diarrhoeal Disease Research (2012) Bangladesh Maternal Mortality and Health Care Survey 2010. Available: http://www.cpc.unc.edu/measure/publications/tr-12-87. Accessed October 15, 2012.b World Health Organization (ND) WHO Maternal Mortality Country Profiles. Available: www.who.int/gho/maternal_health/en/#M. Accessed 1 March 2015.c Lozano R, Wang H, Foreman KJ, Rajaratnam JK, Naghavi M, Marcus JR, et al. (2011) Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis. Lancet 378(9797): 1139–65. 10.1016/S0140-6736(11)61337-8d UNFPA, UNICEF, WHO, World Bank (2012) Trends in maternal mortality: 1990–2010. Available: http://www.unfpa.org/public/home/publications/pid/10728. Accessed 7 October 2012.e Bangladesh Bureau of Statistics, Statistics Informatics Division, Ministry of Planning (December 2012) Population and Housing Census 2011, Socio-economic and Demographic Report, National Series–Volume 4. Available at: http://203.112.218.66/WebTestApplication/userfiles/Image/BBS/Socio_Economic.pdf. Accessed 15 February, 2015.f Mozambique National Institute of Statistics, U.S. Census Bureau, MEASURE Evaluation, U.S. Centers for Disease Control and Prevention (2012) Mortality in Mozambique: Results from a 2007–2008 Post-Census Mortality Survey. Available: http://www.cpc.unc.edu/measure/publications/tr-11-83. Accessed 6 October 2012.g Ministerio da Saude (MISAU), Instituto Nacional de Estatística (INE) e ICF International (ICFI). Moçambique Inquérito Demográfico e de Saúde 2011. Calverton, Maryland, USA: MISAU, INE e ICFI.h Mudenda SS, Kamocha S, Mswia R, Conkling M, Sikanyiti P, et al. (2011) Feasibility of using a World Health Organization-standard methodology for Sample Vital Registration with Verbal Autopsy (SAVVY) to report leading causes of death in Zambia: results of a pilot in four provinces, 2010. Popul Health Metr 9:40. 10.1186/1478-7954-9-40i Central Statistical Office (CSO), Ministry of Health (MOH), Tropical Diseases Research Centre (TDRC), University Teaching Hospital Virology Laboratory, University of Zambia, and ICF International Inc. 2014. Zambia Demographic and Health Survey 2013–14: Preliminary Report. Rockville, Maryland, USA. Available: http://dhsprogram.com/pubs/pdf/PR53/PR53.pdf. Accessed February 26, 2015.j Centers for Disease Control and Prevention (2014) Saving Mothers, Giving Life: Maternal Mortality.Phase 1 Monitoring and Evaluation Report. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services. Available at: http://www.savingmothersgivinglife.org/doc/Maternal%20Mortality%20(advance%20copy).pdf. Accessed 26 February 2015.k Central Statistical Office (CSO), Ministry of Health (MOH), Tropical Diseases Research Centre (TDRC), University of Zambia, and Macro International Inc. 2009. Zambia Demographic and Health Survey 2007. Calverton, Maryland, USA: CSO and Macro International Inc.Comparison of Maternal Mortality Estimates: Zambia, Bangladesh, Mozambique.

*Age−adjusted.Number of maternal deaths/births and maternal mortality ratios (deaths per 100,000 live births) according to the maternal age and year in Taiwan for 2004–2011 based on a nationwide data linkage study.

The National Vital Statistics System (NVSS) provides the most complete data on births and deaths in the United States.

This project provides the revised birth estimates, infant mortality rates, and maternal mortality rates at the state- and national-level and by race.

Colombia CO: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data was reported at 44.000 Ratio in 2017. This stayed constant from the previous number of 44.000 Ratio for 2016. Colombia CO: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data is updated yearly, averaging 59.000 Ratio from Dec 1985 (Median) to 2017, with 32 observations. The data reached an all-time high of 96.000 Ratio in 1985 and a record low of 44.000 Ratio in 2017. Colombia CO: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Colombia – Table CO.World Bank.WDI: Social: Health Statistics. Maternal mortality ratio is the number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births.;The country data compiled, adjusted and used in the estimation model by the Maternal Mortality Estimation Inter-Agency Group (MMEIG). The country data were compiled from the following sources: civil registration and vital statistics; specialized studies on maternal mortality; population based surveys and censuses; other available data sources including data from surveillance sites.;;

The number of maternal deaths and maternal mortality rates for selected causes, 2000 to most recent year.

Estimates based on District hospital discharge data. Counts of and rates based on fewer than 10 births are suppressed for privacy reasons.

Source: Center for Policy Planning and Evaluation, DC Department of Health

Why This Matters

In recent decades, pregnancy-related deaths have risen in the United States. Although relatively rare and mostly preventable, the numbers are high relative to other high-income countries.

Leading underlying causes of pregnancy-related deaths include severe bleeding, cardiac and coronary conditions, and infections. Individual, social, and structural factors contribute to maternal death risk and trends, including maternal age, preexisting medical conditions, access to quality care, insurance, and longstanding racial and ethnic inequities.

Maternal mortality rates are disproportionately higher among birthing people who are Black, Indigenous, and people of color.

The District Response

Enhancements to District healthcare programs. Medicaid expansion provides greater access to prenatal care, extended postpartum Medicaid coverage for a full year, and reimbursement for doula services through all District programs. For a list of local and national resources on pregnancy and related topics, click here.

Paid family leave program providing 12 weeks to bond with a new child or care for a serious health condition, and 2 weeks specifically for prenatal care.

The District established the Maternal Mortality Review Committee, which investigates the causes of maternal deaths, and develops strategic frameworks to improve maternal health.

Data source: Nepal demographic and health surveys 1996 and 2006.amaternal mortality rate from the later survey was used as the reference, so the incidence rate ratio in the earlier survey was 2.69 times greater.**denotes statistical significance at p<0.001;*p<0.01.

(Authors generated the estimate employing the SRS Data [29, 42]).

Abstract

The Government of The Gambia has always been committed to the “Health for All” year 2000 and beyond Alma Ata Declaration (1978) as well as other conventions such as the 1987 Global Conference on Safe Motherhood, the 1990 Convention on the Rights of the Child and the 1994 ICPD-Cairo Plan of Action, amongst others. A unique recommendation from all these conventions was the reduction of maternal mortality by half by the year 2000 and the provision of a comprehensive reproductive health programme using the life cycle approach from birth to death.

The 1987 conference on safe motherhood brought about increased awareness in the health sector on the issue of maternal mortality following which the “sisterhood” method of estimating levels of maternal mortality was first tested in The Gambia in 1987. This field test was done by the MRC field station located in one of the rural divisions of The Gambia and a total of 90 maternal deaths were identified. The lifetime risk of maternal death was estimated to be higher than one woman in twenty (Greenwood et al.). Subsequently, this revelation by the MRC study sparked a new impetus into the “silent epidemic” of maternal mortality following which the Department of State for Health through its MCH/FP programme commissioned a national survey in 1990. The results, which were quite startling, revealed a maternal mortality level of 1,050 per 100,000 live births nationally. There were variations between urban (600 per 100,000) and rural communities with trained birth attendants (894 per 100,000), and communities without trained birth attendants (1,600 per 100,000).

Recent isolated studies on maternal mortality have suggested a general decline in those areas. However, in the absence of a viable vital registration system in The Gambia, there has been a felt need to conduct another national survey, since the 1990 survey. Furthermore, the Department of State for Health’s proposed shift from MCH/FP service provision into a broad-focussed reproductive health programme also requires the availability of current baseline information and the identification of relevant process indicators, all of which justify the need to establish current levels of mortality and use of contraceptives.

It should be noted that current national policies and programmes continue to refer to data obtained from the 1990 maternal mortality study, the 1990 Gambia contraceptive prevalence and fertility determinants survey as well as the 1993 population and housing census as baseline benchmarks both for programme intervention and implementation. This long period to some extent renders the data quite obsolete and unsuitable for many national and development purposes. A simple compromise has been that of making comprehensive demographic, health and socio-economic projections. However, one important limitation of statistical projections is the period between the time the base data were collected and the time span of the projections. The probable margin of error in making projections with reference periods of eight or more years ago could be so large to warrant the acceptance of such projections within any reasonable statistical intervals.

Since there has been no comprehensive national survey on maternal, infant and child mortality during the past 10 years, and given that it would take a number of years before the final analyses of data obtained from the forthcoming census, it was found prudent to carry out a comprehensive study that would collect information on key reproductive health indicators. Furthermore, the complexity involved in studying maternal mortality compounded by its rarity of occurrence in the general population has necessitated conduction of a specialised study. Such a study would be useful in filling in the data deficiencies and providing baseline data for programme intervention and evaluation, especially in an era of a general shift of emphasis of population programmes from vertical family planning activities in favour of a more generally accepted concept - reproductive health.

Objectives of the survey: a) To establish current levels of maternal, peri-natal, neonatal and infant mortality rates. b) To establish the current levels of contraceptive prevalence rates and barriers to use. c) To elicit how the situation has improved or otherwise during the last ten years. d) Make practical recommendations to Department of State for Health for subsequent and long-term actions required.

Geographic coverage

National.

Analysis unit

• Households
• Women and men (both in child-bearing age)

Universe

The survey covered women age 15 to 49 years old and men age 18 years and over.

Kind of data

Sample survey data [ssd]

Sampling procedure

A multi-stage stratified cluster sampling procedure was used for this study. The country is divided into 41 Districts and each of these districts was identified as a stratum. Stratification by districts increases the efficiency of the sample given the homogeneity of the districts. The sample size for the study was 4000 households and was based on the level of maternal mortality which was estimated at 1050 per 100,000 at the time of the study. According to WHO/UNICEF, 1997 publication on Sisterhood Method in Estimating Maternal Mortality, 4,000 households or less would be adequate for study of maternal mortality if the level of maternal mortality is at least 500 per 100,000.

Based on the Rule of Thumb, a 15 per cent sample of EAs (240) was selected for this study, which is also more than adequate for the study of other variables like contraceptive prevalence, infant mortality, fertility and its determinants. The selection of population elements were done at two stages; a representative sample of 240 Enumeration Areas (EAs) were randomly selected and allocated based on the Probability Proportional to the Size (PPS) of the district using random numbers. The EA is a cluster of settlements with an estimated population of 500 peoples.

A total of 4,000 households were then allocated to the districts with probability proportional to the size of each district. For the 240 selected EAs, a specified number of households were randomly selected for interview using a systematic sampling procedure. A complete listing of selected household members was done and all eligible male and female respondents were interviewed.

Sampling deviation

There were no discrepancies between the sample units obtained and the iniitial planned samples.

Mode of data collection

Face-to-face [f2f]

Research instrument

The survey tools included a compound and household schedules, female and male questionnaires. The compound and household schedules were used to collect information on local government area, health division and household number, together with residence, sex, age, education and eligibility status of the household members. The female and male questionnaires were administered to women aged 15-49 years and men aged 18 years and above respectively. The survey instruments were similar to the core modules of the Demographic and Health Survey questionnaires (Macro International), with adaptation to suit The Gambian needs. In addition a review of medical records in the three main hospitals in The Gambia (Royal Victoria Hospital, Farafenni Hospital and Bansang Hospital) was carried out in November 2001 to undertake first-hand assessment of the maternal mortality situation at the major referral facilities.

The Survey team with support and guidance of the Technical Team prepared the survey instruments by adapting the Demographic and Health survey modules. The main instruments for this study are: - Male questionnaire which was used to obtain information from males 18 years and above; - Female questionnaire, which obtained information from females, 15-49 years ; - Household questionnaire contains information on Local Government Area (LGA), Districts and Household numbers.

For each person listed on the household questionnaire, relationship to head of household, age, and sex are recorded.

The female questionnaire contains the following key information: - Respondent's background - Reproduction - Contraception - Marriage - Fertility preferences - Maternal mortality

The male questionnaire on the other hand, contained the following information: - Respondent's background - Contraception - Marriage - Maternal mortality

Response rate

All respondents with missing age were excluded from the model. There were about 15 percent of the responses with missing information on the deaths. Imputations were made to establish whether or not they qualified to be classified as maternal deaths. For instance, those missing sex of the sibling but had correctly answered maternal death-related questions, the sex was taken to be female and therefore included in the maternal mortality model. Responses with no information on the type of maternal death, but had indicated the death as having been as a result of complications of pregnancy or child birth, were imputed to be pregnancy-related. On the other hand, responses on symptoms before death were used to impute the type of death in case it was missing.

Data appraisal

All respondents with missing age were excluded from the model. There were about 15 percent of the responses with missing information on the deaths.

Poland PL: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data was reported at 2.300 Ratio in 2011. This records an increase from the previous number of 1.900 Ratio for 2009. Poland PL: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data is updated yearly, averaging 3.450 Ratio from Dec 2001 (Median) to 2011, with 6 observations. The data reached an all-time high of 4.600 Ratio in 2008 and a record low of 1.900 Ratio in 2009. Poland PL: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Poland – Table PL.World Bank: Health Statistics. Maternal mortality ratio is the number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births.; ; UNICEF, State of the World's Children, Childinfo, and Demographic and Health Surveys.; ;

Maternal mortality (ICD-10 O0-O99). To reduce maternal deaths. Legacy unique identifier: P00615