Introduction

In 1990, an estimated 870 women died for every 100,000 live births in Bangladesh. By 2023 the ratio had fallen to 115 — a drop of 87% in just over three decades.1

870 → 115

Maternal deaths per 100,000 live births in Bangladesh, 1990 to 2023.

That is one of the country’s great public health achievements. But it is not finished: thousands of women still die every year from causes that are largely preventable, and the next stretch of progress will be harder than the last.

A long decline

Childbirth has become far safer for Bangladeshi mothers
Maternal deaths per 100,000 live births (modelled estimate), 1990–2023
Source: WHO, UNICEF, UNFPA, World Bank and UN DESA, Trends in Maternal Mortality, via World Bank WDI (SH.STA.MMRT)

The fall has been remarkably steady. The ratio dropped from 870 in 1990 to 523 in 2000, halved again to 275 by 2010, and kept falling through the 2010s, to 152 in 2020.1

The one break came in 2021, when the estimate rose to 194 — a year that coincided with the COVID-19 pandemic and its disruption of routine health services. By 2022 it had fallen back to 131, and to 115 in 2023.1

These are modelled estimates, produced by UN agencies from household surveys, health records and statistical models, so small year-to-year changes should be read with caution. The long-term direction is not in doubt.

Who is at the birth

Six in ten births now have a skilled attendant
Births attended by skilled health staff (% of total), by survey year
Source: UNICEF State of the World's Children, from DHS and MICS surveys, via World Bank WDI (SH.STA.BRTC.ZS)

Most maternal deaths are caused by complications — heavy bleeding after birth, eclampsia, infections, obstructed labour — that a trained doctor, nurse or midwife can recognise and manage, or refer in time. That is why the share of births with a skilled attendant is one of the most closely watched measures of maternal care.

In 1994, fewer than one in ten births in Bangladesh had a skilled attendant. The share passed 40% in 2014 and reached 59% in the 2019 survey.2 That still means roughly four in ten births happened without one, most of them at home.

What it will take

The Sustainable Development Goals aim to bring the global maternal mortality ratio below 70 per 100,000 live births by 2030.3 To get there from 115 in 2023, Bangladesh would need to cut the ratio by about 7% a year — slightly faster than its average over the past decade, and at a stage where the remaining deaths are harder to prevent.

The evidence points to a few priorities:

  • A trained attendant at every birth, with more midwives in rural and hard-to-reach areas, where home births are most common.
  • Emergency obstetric care within reach, so that a woman with a complication can get to a facility that can treat it in time.
  • Care before and after birth, since many risks can be spotted in antenatal check-ups and many deaths happen in the days after delivery.
  • Better data, because many maternal deaths go unrecorded; stronger death registration would show where women are still dying and why.

Endnotes

  1. WHO, UNICEF, UNFPA, World Bank Group and UN DESA Population Division, Trends in Maternal Mortality (modelled estimates), via World Bank World Development Indicators (SH.STA.MMRT). ↩ ↩2 ↩3

  2. UNICEF, The State of the World’s Children, from Demographic and Health Surveys and Multiple Indicator Cluster Surveys, via World Bank World Development Indicators (SH.STA.BRTC.ZS). ↩

  3. United Nations, Sustainable Development Goal target 3.1. ↩