The health of mothers and babies is the foundation of healthy families and communities, providing hopeful futures for us all
World Health Day is celebrated on 7 April each year and this year it kicked off a year-long campaign on maternal and newborn health. This World Health Organsation’s (WHO) campaign, titled ‘Healthy beginnings, hopeful futures’, urges governments and the health community to ramp up efforts to end preventable maternal and newborn deaths, and to prioritise women’s longer-term health and well-being.1 The aim of this blog is to raise awareness of this global issue but also highlight the challenges in the UK and act as a reminder that failing to prioritise the health of new mothers and babies undermines the foundation of healthy families and communities.
Helping every woman and baby survive and thrive.
Tragically, based on currently published estimates, close to 300,000 women lose their life globally due to pregnancy or childbirth each year, while over two million babies die in their first month of life and around two million more are stillborn.2 That is roughly one preventable death every seven seconds. Approximately 92 per cent of all maternal deaths occurred in low and lower middle-income countries, reflecting inequalities in access to quality health services and the gap in outcomes between rich and poor. The maternal mortality rate in low-income countries in 2023 was 346 per 100 000 live births versus 10 per 100 000 live births in high income countries. Yet almost all maternal deaths are preventable with scientific and medical knowledge available to ensure positive outcomes.3
Globally, the leading causes of maternal death are haemorrhage (severe bleeding) and hypertensive disorders such as pre-eclampsia. Other direct causes include sepsis and other infections, pulmonary embolism, complications from both spontaneous and induced abortions (including miscarriage, ectopic pregnancy, and unsafe abortion), and anaesthetic complications and childbirth injuries.4
Maternal and newborn health are inextricably linked, with disparities in one often reflected in the other. Indeed, an estimated 2.3 million newborns died in 2023, while 4.9 million children died before their fifth birthday from largely preventable causes, and there were 1.9 million stillbirths. Low and middle-income countries account for the majority of these deaths, yet many are deemed preventable.5
Based on current trends four out of five countries are off-track to meet their WHO targets for improving maternal survival by 2030 and a third will fail to meet their targets for newborn deaths. Current rates of decline in maternal mortality would need to be accelerated nine times, and for newborn and under-5 mortality four times, to achieve these targets.6 This is not just about access to care as even in high income countries preventable maternal prenatal and new-born deaths are a feature of many healthcare systems and highlight the importance of high quality physical and mental health services and support before during and after birth.
The situation in the UK
In the UK, the annual MBRACE report examines research data over a three-year rolling framework. The 2025 report (covering 2021-2023) estimates a rate of 12.67 deaths per 100,000 maternities.7 This compares to a rate of 13.56 in 2020-2022 and 10.90 in 2018-2020 per 100,000 maternities, and is significantly higher than the pre-pandemic rate of 8.79 in 2017-2019.8 When deaths from complications due to COVID-19 infections are excluded, the rates for 2020-2022 and 2021-2023 would have been 11.68 and 11.23 per 100,000 maternities respectively - still notably higher than pre-pandemic levels.9
In 2021-2023, thrombosis and thromboembolism remained the leading causes of maternal death, as it was in 2020-2022. Cardiac disease was the second leading cause followed by COVID-19, and it is noted that in 2023 there were no deaths due to COVID-19. The next most common direct cause of maternal death was sepsis due to pregnancy-related conditions, followed by suicide, obstetric haemorrhage, and deaths in early pregnancy. After cardiac disease and COVID-19, the next leading indirect cause of maternal deaths in 2021-2023 was neurological conditions.
Inequalities in maternal mortality continued in 2021-23. Compared to women aged 20-24, women aged 35 or older were three times more likely to die. While the maternal mortality rate for women from Black ethnic backgrounds continued to decrease in 2021-23, there remained a two-fold difference in maternal mortality rates for Black women compared to White women. Asian women also had a slightly increased risk compared to White women. Women living in the most deprived areas continued to have a maternal mortality rate twice that of women living in the least deprived areas.10
Despite the UK's robust healthcare system, equitable access to women's health services remains a challenge. Long waiting times for specialist appointments, especially in gynaecology and mental health, can significantly impact women's well-being. Some of the specific areas of concern affecting women’s health during their reproductive years include: reproductive health (access to contraception, safe abortion and addressing the rising rates of sexually transmitted infections); maternal mental health, especially perinatal challenges; and chronic conditions like endometriosis and polycystic ovary syndrome (PCOS) which far too often go undiagnosed or misdiagnosed, leading to delayed treatment and long-term health consequences.
The stark reality of disparities
As demonstrated by the above facts and figures, the disparities in maternal and neonatal health outcomes are not random; they are rooted in systemic inequalities related to race, ethnicity, socioeconomic status, and access to quality healthcare.
Socioeconomic disparities, including poverty, lack of education, and limited resources, create significant barriers to maternal and neonatal care. Women in lower socioeconomic groups often struggle to access timely prenatal care, nutritious food, and essential medications, contributing to adverse outcomes. Geographic location also plays a crucial role, with women in rural areas facing longer distances to facilities, provider shortages, and limited access to specialised services, leading to delays in care and increased complication risks.
Addressing these disparities requires a multi-pronged approach.
The aims of the Healthy beginnings, hopeful futures campaign are:
- to raise awareness about gaps in maternal and newborn survival and the need to prioritise women’s longer-term well-being.
- to advocate for effective investments that improve the health of women and babies.
- to encourage collective action to support parents as well as health professionals who provide critical care.
- to provide useful health information relating to pregnancy, childbirth, and the postnatal period.11
Achieving these aims requires a commitment to invest in women's health throughout their lives, including:
- strengthening antenatal and maternity services and ensuring access to comprehensive primary care services, including preventative screenings and health promotion programmes
- investing in maternal healthcare such as improving access to quality antenatal, delivery, and postnatal care, particularly in underserved communities
- addressing social determinants of health by tackling poverty, improving education, and promoting gender equality
- promoting mental wellbeing by integrating mental health services into primary care and providing accessible mental health support for women of all ages
- empowering women by providing them with the information and resources they need to make informed decisions about their health.
Conclusion
World Health Day, and the year-long campaign to improve maternal and newborn health, provides us all with an opportunity to reaffirm our commitment to building a future where every woman can live a long, healthy, and fulfilling life. By working together, we can create a world where ‘healthy beginnings’ truly lead to ‘hopeful futures’. Importantly, all countries need to evolve their health systems to manage the many health issues that impact maternal and new born, including direct obstetric complications, but also mental health conditions, non-communicable diseases, and family planning. Equally important is the need for laws and policies that support women and families everywhere by safeguarding their health and rights.
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