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.