While some progress has been made in reducing maternal
mortality, the rate of decline is far from adequate for
achieving the goal. Moreover, for every death, approximately
20 women suffer from injury, infection, disease or disability
as a result of complications arising from pregnancy or
childbirth. Most maternal deaths can be prevented if births
are attended by skilled health personnel – doctors, nurses,
midwives and auxiliary midwives – who are regularly
supervised, have the appropriate equipment and supplies,
and can refer women in a timely manner to emergency
obstetric care services when complications are diagnosed.
The coverage of skilled attendance at delivery has increased
in all regions. Despite this, less than half of births in South
Asia and sub-Saharan Africa are attended by skilled health
personnel. In some countries of these regions, fewer than
half of births occur in a health facility.
In all regions, women from the richest 20 per cent of
households are more likely than those from the poorest
20 per cent of households to deliver their babies with the
assistance of skilled health personnel. The difference ranges
from 1.7 times more likely in East Asia and the Pacific
(excluding China) to 4.9 times more likely in South Asia.
In 5 to 15 per cent of births, the baby needs to be delivered
by Caesarean section (C-section). Recent data from nine
sub-Saharan African countries, which account for almost two
thirds of the total number of births in the region, suggest that
women in rural areas, in particular, lack access to C-sections,
an essential part of comprehensive emergency obstetric care.
A C-section rate below 5 per cent indicates that many women
who need the procedure are not undergoing it, which
endangers their lives and those of their babies.