Kadzo Mweu's voice quivers at the first touch of an unpleasant memory as she recalls the journey of her second pregnancy.
"I almost didn't make it," the 32-year-old mother of two from Kenya tells TRT Afrika. "After giving birth to my second child, I started bleeding heavily. The nurses were rushing around, and I could see alarm in their eyes. I didn't know if I would survive to see my baby grow up."
For Bayo Godwin, a 28-year-old father from Nigeria, the trauma of seeing his wife die in his arms soon after childbirth is still raw.
"We were so excited to welcome our first child," he recalls. "After the delivery, my wife started bleeding uncontrollably. The hospital didn't have the right equipment or blood supply to save her. She died as I held her and she cradled our newborn son. I became a father and a widower in the same moment."
Bayo and Kadzo aren't alone in their pain. Millions of women and their families in Africa and elsewhere suffer the shock and uncertainty wrought by life-threatening complications during pregnancy and childbirth every year.
According to a new study by the World Health Organisation (WHO), severe bleeding (haemorrhage) and hypertensive disorders like preeclampsia are the leading causes of maternal deaths globally.
In 2020 alone, excessive bleeding and preeclampsia claimed approximately 80,000 and 50,000 lives, respectively.
Published in The Lancet Global Health journal, the study underscores the need for improved access to lifesaving treatments and comprehensive maternal care.
This community health nurse has made it his life's work to reduce mortality among expectant mothers and newborns in Ghana's hinterland, often travelling solo to villages with an ultrasound machine to help those who can't afford preventive scans.
Preventable deaths
Dr Pascale Allotey, director of sexual and reproductive health and research at WHO, believes pregnancy-linked deaths should be an aberration rather than a widespread occurrence in the modern world.
"Understanding why pregnant women and mothers are dying is essential to addressing the global maternal mortality crisis," she says in a news release commemorating International Women's Day on March 8. "This isn't just a health issue, it's a matter of equity. Every woman, everywhere, has the right to high-quality, evidence-based care before, during, and after childbirth."
In 2020, an estimated 287,000 women died from pregnancy-related causes—equivalent to one death every two minutes. Haemorrhage, which often occurs during or after childbirth, accounted for 27% of these deaths, while preeclampsia and other hypertensive disorders contributed to 16% of these casualties.
Underlying causes
The WHO study highlights that nearly a quarter (23%) of maternal deaths are linked to underlying health conditions such as HIV/AIDS, malaria, anemia and diabetes. These conditions often go undetected or untreated, exacerbating risks during pregnancy.
Dr Jenny Cresswell, a WHO scientist and co-author of the study, highlights the interconnected risks.
"Conditions like preeclampsia not only raise the risk of haemorrhage but can also lead to complications that persist well beyond childbirth. To ensure women have the best chance of survival and lasting health, we must adopt a comprehensive, holistic approach to maternal care," she says.
Other direct causes of maternal mortality include sepsis, infections, pulmonary embolism, complications from abortion and injuries during childbirth.
Postnatal gap
Despite the critical importance of postnatal care, around one-third of women in low-income countries do not receive essential check-ups in the days following childbirth. This gap in care is particularly alarming, as most maternal deaths occur during or shortly after delivery.
"After my baby was born, I was so focused on her that I neglected my health," says Chiedza Chimbiri, a 25-year-old mother in Zimbabwe who experienced postpartum depression. "It wasn't until months later that I sought help. By then, I felt like I was drowning."
Mental health support is a glaring omission in many maternal care systems.
The WHO study reveals that data on maternal suicide is available for only 12 countries worldwide, highlighting a significant knowledge gap. Additionally, late maternal deaths—those occurring up to a year after childbirth—are rarely reported, despite the long-term risks women face.
Esther Muthoni's husband died shortly after transforming their family home into a small healthcare centre. She then soldiered on to keep afloat Zamzam Medical Services, a facility that now serves over 13,000 people every year.
Call to action
In response to these challenges, WHO has launched a global Roadmap for Postpartum Haemorrhage, outlining key priorities to address this leading cause of maternal death, with the 194 member states of the World Health Assembly committing to strengthening quality care before, during and after childbirth.
Ahead of World Health Day 2025, to be commemorated on April 7, the campaign highlights maternal and newborn health, aligning with the five-year mark since the Sustainable Development Goals deadline. The campaign seeks to mobilise global action to guarantee access to high-quality care, especially in low-income countries and crisis-affected regions, where the burden of maternal deaths is heaviest.
"We need to do more than save lives," says Dr Allotey. "We need to ensure that women can thrive after childbirth, with access to comprehensive care that addresses their physical, mental, and emotional well-being."
Change in the offing
For women like Kadzo and Chiedza, the path to recovery was fraught with challenges, but their stories also offer hope.
"I want every woman to have the chance to hold their baby and watch them grow," Kadzo tells TRT Afrika. "So many mothers are at risk, and I believe none should have to lose her life to bring a child into the world."
For Bayo, the fight for better maternal health is deeply personal. "I don't want any other family to go through what I did,” he says. “My wife’s death was preventable. If the hospital had the right resources, she would still be here. We need to do better—for mothers, for fathers, and children."
