Maternal Mortality Persists Across the Americas: PAHO

Maternal mortality remains a significant public health challenge across the Americas, according to the PAHO. In 2023, nearly 8,000 women died from pregnancy- and childbirth-related causes, with a regional maternal mortality ratio of 59 deaths per 100,000 live births, above the target of 30 set for 2030. Although countries reduced maternal deaths by 17% after the COVID-19 pandemic, gaps in access to healthcare services persist, particularly among vulnerable populations such as Indigenous women.

Maternal mortality remains a persistent public health challenge across the Americas, highlighting structural gaps in health systems, workforce capacity and access to essential services for women, according to the Pan American Health Organization (PAHO).

On International Women’s Day, observed each year on March 8, PAHO called on governments and health stakeholders to accelerate efforts to reduce maternal mortality and ensure women have access to essential health services, medicines and technologies required for safe pregnancy and childbirth. The organization emphasized that strengthening health systems and expanding the health workforce are central to addressing preventable maternal deaths.

Despite progress in recent decades, maternal mortality remains above regional targets. In 2023, nearly 8,000 maternal deaths were recorded across the Americas, representing a maternal mortality ratio of 59 deaths per 100,000 live births. This figure remains significantly higher than the regional goal of 30 deaths per 100,000 live births established under PAHO’s Sustainable Health Agenda for the Americas 2030.

The COVID-19 ‘Recovery Process’

The COVID-19 pandemic exposed weaknesses in health systems and deepened existing inequalities, temporarily increasing maternal mortality across the region. In the years following the pandemic, countries implemented coordinated responses that reduced maternal deaths by 17%, an improvement that PAHO estimates translates into saving the lives of approximately five pregnant women each day.

However, the recovery has not fully closed the structural gaps that limit access to maternal and neonatal health services. According to James Fitzgerald, Director of the Department of Health Systems and Services, PAHO, disparities continue to affect populations living in vulnerable conditions.

“Despite this recovery, gaps in access to maternal and neonatal health services continue to disproportionately affect populations in situations of greater vulnerability,” said Fitzgerald .

These disparities are particularly visible among Indigenous populations. In several countries across Latin America and the Caribbean, Indigenous women face up to three times the risk of dying during pregnancy or childbirth compared with other groups, reflecting differences in access to timely care, health infrastructure and trained personnel.

Preventable Causes and Workforce Expansion

Most maternal deaths in the region are linked to preventable causes. Postpartum hemorrhage, hypertensive disorders of pregnancy such as preeclampsia and eclampsia, and severe infections associated with pregnancy remain the leading factors. Health authorities note that the majority of these cases could be avoided through timely medical intervention, access to appropriate medicines and the availability of trained health workers capable of providing evidence-based care.

Expanding the health workforce is therefore a critical component of maternal health strategies. PAHO has emphasized the importance of ensuring that health systems have sufficient numbers of well-trained and well-distributed professionals capable of delivering maternal, sexual and reproductive health services. Strengthening the capacity of nurses, midwives, obstetricians and community health workers can improve early detection of complications and increase the availability of care during pregnancy and childbirth.

“Strengthening access to essential medicines, maternal and neonatal health technologies, and comprehensive health services is necessary to reduce mortality among women and newborns,” Fitzgerald said.

Strategic Initiatives and Resource Procurement

To accelerate progress, PAHO launched the Zero Preventable Maternal Deaths initiative in 2024, calling on governments across the Americas to prioritize maternal health through stronger policy commitments and targeted investment. The initiative encourages countries to allocate adequate financing for maternal health programs, promote intersectoral collaboration to address barriers to care, and implement social mobilization strategies that increase awareness of maternal health risks.

The initiative also places emphasis on strengthening governance and management within health systems. According to PAHO, improving coordination across national and local health authorities is essential to ensure that maternal health services reach populations with limited access to care.

Another central component of the strategy involves expanding primary health care and strengthening integrated health service networks. By reinforcing the primary care model, health systems can provide earlier prenatal monitoring, identify complications and facilitate referrals to specialized services when necessary. This approach also allows health providers to maintain closer contact with communities and ensure continuity of care throughout pregnancy.

Workforce planning plays a central role in this strategy. PAHO has stressed the importance of building a health labor force that is sufficiently trained, motivated and distributed across both urban and rural areas. In many countries, shortages of health professionals in remote regions remain a barrier to timely maternal care, contributing to disparities in outcomes.

Beyond workforce expansion, the organization has also focused on improving access to medicines and medical technologies. Recently, PAHO strengthened its technical cooperation by launching essential maternal and neonatal health supply packages. These packages include a catalogue of priority medicines, medical devices and equipment designed to support the treatment of pregnancy-related complications.

Through the organization’s Regional Revolving Funds, countries can jointly procure these supplies in a coordinated manner, improving affordability and ensuring that health facilities maintain adequate inventories of life-saving medicines and equipment.

The initiative aims to support health systems in strengthening the operational capacity required to address maternal complications, particularly in facilities serving rural and underserved populations.

PAHO also emphasizes the role of community engagement in reducing maternal mortality. Empowering women, families, and communities to recognize warning signs during pregnancy and to seek timely care can help prevent complications from escalating. Education campaigns and community health programs are therefore considered essential components of maternal health policies.

Maternal Deaths in Mexico 

Mexico’s Ministry of Health recorded 534 maternal deaths in 2024 and 88 in early 2025, reports MBN.  Women aged 45 to 49 had the highest maternal mortality ratio at 164.6 per 100,000 live births. Hypertensive disorders, abortion and obstetric complications were among the leading causes.

Inequality remains a defining factor. A study by Mexico’s National Institute of Public Health found that effective maternal health coverage for indigenous women was 18.3% between 2009 and 2023, compared with 25.3% for non-indigenous women. Coverage declined after the transition from Seguro Popular to INSABI and during the COVID-19 pandemic, particularly in remote communities.

The study cited discrimination based on gender, ethnicity and socioeconomic status as compounding barriers. Researchers recommended integrating anti-discrimination measures at clinical, administrative and regulatory levels and strengthening culturally sensitive care models.

Mexico has introduced NOM-020-SSA-2025 to formally incorporate professional and traditional midwives into the national health system and establish midwifery houses and low-risk birthing units. Authorities state the regulation aims to expand access, improve cultural safety and reduce preventable complications.

Clinical practices also shape outcomes. National data show that cesarean deliveries in Mexico rose from 45% in 2010 to 55% in 2023, with rates reaching as high as 80% to 90% in some private facilities. Research from the National Institute of Public Health found that early-term births increased as scheduled cesareans shifted gestational age earlier. Babies delivered by cesarean averaged slightly lower birth weights and shorter length compared with vaginal births.