Pakistan remains among the countries carrying a disproportionately heavy share of the global maternal mortality burden, with a recent United Nations report highlighting the scale of the challenge and the urgent need for stronger healthcare systems, greater investment and wider social reforms.
In 2023, Pakistan, Nigeria, India and the Democratic Republic of the Congo together accounted for nearly half of the estimated 260,000 maternal deaths recorded worldwide. Nigeria alone reported around 75,000 deaths, representing 28.7 percent of the global total, while India and the DRC each recorded about 19,000 deaths. Pakistan accounted for approximately 11,000 maternal deaths, or 4.1 percent of the worldwide figure.
The statistics are deeply troubling because most maternal deaths are preventable. They are not simply an unavoidable consequence of pregnancy or childbirth. With timely access to quality antenatal care, skilled birth attendants, emergency obstetric services and appropriate postnatal treatment, many women who currently die could survive.
The report, prepared jointly by UNICEF, the World Health Organization (WHO) and UNFPA, also offers a mixed picture globally. Maternal mortality has fallen significantly since 2000, with an overall decline of around 40 percent. Improvements in access to healthcare and maternal services have contributed to this progress. Yet the gains have been highly uneven, and recent disruptions to health services and international aid have raised fears that progress could slow or even be reversed.
The threat is particularly serious in low-income and crisis-affected countries where health systems are already under enormous pressure. Reductions in international development assistance can force governments and aid organisations to scale back programmes that provide essential maternal and child health services. For women living in remote or impoverished communities, the disappearance of such services can mean the difference between a safe delivery and a preventable death.
The COVID-19 pandemic demonstrated how quickly maternal health can deteriorate when essential services are disrupted. Maternal deaths increased sharply during the pandemic as healthcare systems were overwhelmed and women faced difficulties accessing antenatal care, skilled delivery services and emergency treatment. The disruption showed that maternity services cannot be treated as optional during national or international emergencies.
Improving maternity care must consequently go hand in hand with broader investments in women’s health and reproductive rights. Women need access to family planning, accurate health information and quality healthcare before, during and after pregnancy. Without these services, women can be exposed to repeated and closely spaced pregnancies that increase risks to both mothers and children.
The consequences of maternal deaths extend beyond the women who lose their lives. When a mother dies during pregnancy or childbirth, her newborn is also placed at much greater risk. Children who lose their mothers face greater vulnerability to malnutrition, poor health, interrupted education and poverty. Families can lose their primary caregiver, while communities suffer the loss of productive members.
This makes maternal health both a healthcare issue and a development issue. UNICEF has stressed the importance of investing in midwives, nurses and community health workers, particularly in vulnerable communities. These frontline workers often serve as the first and sometimes only point of contact between women and the formal healthcare system. Ensuring that they have adequate training, supplies and institutional support can significantly improve maternal and newborn outcomes.
The global figures also reveal a stark geographical imbalance. Sub-Saharan Africa accounted for around 70 percent of maternal deaths in 2023, despite recording important progress over the longer term. Poverty, weak healthcare systems, limited access to skilled medical professionals and armed conflict continue to make pregnancy especially dangerous in many parts of the region.
Nearly two-thirds of maternal deaths now occur in fragile or conflict-affected settings. In such environments, hospitals may be damaged or inaccessible, medical supplies may be scarce and trained healthcare workers may flee violence. Women may also face displacement, food insecurity and restricted access to reproductive healthcare.
Pakistan has its own complex set of challenges. Poverty, inadequate healthcare infrastructure, especially in rural areas, limited access to family planning and low levels of awareness all contribute to maternal and infant mortality. For many women, reaching a facility capable of providing emergency obstetric care can itself be a major challenge.
The problem is compounded by early and underage marriage. In Sindh, the Child Marriages Restraint Act of 2013 was intended to prevent child marriage, but weak enforcement remains a serious concern. Girls married at a young age are more likely to become pregnant before their bodies are fully prepared for childbirth and may subsequently experience repeated pregnancies.
Early marriage also frequently interrupts education. Once girls leave school, they are less likely to receive accurate information about reproductive health, family planning and their legal rights. Their ability to make informed decisions about pregnancy and healthcare can consequently be severely restricted.
Keeping girls in school is therefore one of the most effective long-term investments Pakistan can make in maternal health. Education improves health awareness, expands economic opportunities and increases women’s ability to make informed decisions about marriage and childbearing. Educated women are also generally better positioned to seek medical assistance when complications arise.
Family planning must form another central component of the national response. Women should be able to determine when and how many children they wish to have and should have access to safe and affordable reproductive healthcare. Preventing unintended and closely spaced pregnancies can reduce health risks for mothers and newborns alike.
Maternal health policies must also address conditions such as anaemia, malaria and chronic diseases that can complicate pregnancy. Improving nutrition and strengthening primary healthcare would help identify risks earlier and enable women to receive treatment before relatively manageable conditions become life-threatening.
Better data are equally important. Governments need reliable, detailed information to identify communities and groups facing the highest risks. Without accurate district-level data, resources may not reach the women who need them most. Stronger monitoring systems can also help authorities measure whether programmes are delivering meaningful improvements.
The international community has an important role to play, particularly at a time when reductions in development assistance threaten programmes in vulnerable countries. However, Pakistan cannot rely indefinitely on external funding. Sustainable progress requires domestic political commitment, adequate public financing and health systems capable of delivering essential services consistently.
Maternal mortality should therefore be viewed as a measure of the strength and fairness of the wider healthcare system. A country that cannot ensure safe pregnancy and childbirth for its poorest women cannot claim to have achieved meaningful health equity.
The way forward is clear, even if implementation is difficult. Pakistan needs stronger primary healthcare, better-equipped maternity facilities, more trained midwives and nurses, wider access to family planning, improved maternal nutrition and effective enforcement of laws against underage marriage. It must also keep girls in school and give them the knowledge and opportunities needed to make informed choices about their lives.
Preventing maternal deaths is not merely about saving lives at the moment of childbirth. It is about protecting families, improving child welfare, strengthening human capital and creating healthier communities.
The UN findings should therefore serve as a call to action rather than another alarming statistic. Medical solutions exist, but they will work only when women can actually reach them. Pakistan must invest not only in hospitals and healthcare workers but also in girls’ education, reproductive rights, social protection and economic opportunity.
Saving mothers means protecting the next generation. Investing in maternal and newborn health is not simply a humanitarian obligation; it is an investment in Pakistan’s human potential and in the country’s long-term social and economic future.