Key Points

•     Maternal mortality remains unacceptably high in India, even though this hard-to-measure
indicator has likely recently started to decline. For 2005–2006, mortality ratios range from the
Indian government’s estimate of 301 maternal deaths per 100,000 live births, to the World
Health Organization’s estimate of 450.
•     The government’s state-level estimates range from 517 maternal deaths per 100,000 live
births in the most populous state, Uttar Pradesh, to 110 in the small state of Kerala.
•     India contributes nearly one-quarter of the world’s maternal deaths, so its insufficient progress
in reducing maternal mortality imperils not only its own targets, but also the global
achievement of the Millennium Development Goal to reduce maternal mortality by 75% from
1990 levels by 2015.
•     A recent decline in fertility (from 3.4 children per woman in 1993 to 2.7 children in 2006) has
greatly helped to lower the number of Indian women dying from these causes and their lifetime
risk of maternal death.
•     Hemorrhage is the leading cause of maternal death in India; it is responsible for nearly twofifths
of all maternal deaths and thus accounts for half of the direct causes.
•     Women’s receipt of any professional prenatal or delivery care has increased dramatically—
by one-half and one-third, respectively, from 1993 to 2006.
•     Nonetheless, just over half (52%) of all Indian women deliver without trained medical assistance.
Nearly three-fourths of women still give birth with no medical professional in attendance
in Uttar Pradesh and Bihar, the country’s first and third most populated states, respectively.
•     Recently enacted programs to improve the safety of pregnancy and childbirth are likely
behind the substantial increase in the proportion of women attended by trained professionals
at delivery.
•     Nevertheless, if India is to achieve its goal of 100 maternal deaths per 100,000 live births,
government at all levels must redouble efforts to improve access to information and services
to protect women’s health during pregnancy and delivery, and to prevent unintended pregnancy
and unsafe abortion.