Over 529,000 women die annually fromcomplications during pregnancy, childbirth, or thepostpartum period. Nearly all of these deaths occur indeveloping countries, where fertility rates are higher and awoman's life time risk of dying during pregnancy andchildbirth is over 400 times higher than in developedcountries. Additionally, an estimated 20 million womenendure lifelong disabilities such as pelvic pain,incontinence, obstetric fistula, anemia and infertility. Themain direct causes of maternal death are severe bleeding,unsafe abortion, infection, eclampsia, and obstructed labor;the indirect causes include anemia, malaria, heart disease,and HIV. Pregnancy complications are the main cause of deathfor women aged 15-19. High maternal mortality rates in manycountries result from poor reproductive health care,including not having access to skilled care during pregnancyand childbirth and access to safe abortion even where it islegal, especially for the poorest women. Risks of pooroutcomes during pregnancy and childbirth are exacerbated bypoverty, low status of women, lack of education, poornutrition, heavy workloads and violence. While many factorscontribute to maternal death, one of the most effectivemeans of preventing maternal health is to improve healthsystems and primary health care to ensure availability ofskilled attendance at all levels and access to 24-houremergency obstetric care. Family planning services couldalso reduce maternal deaths and morbidities by 30 percent.Prevention of unwanted pregnancies and access to safeabortion as allowed by law and post abortion care servicescould reduce maternal deaths and injuries caused by unsafeabortions - over 68,000 women die from unsafe abortions annually.
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