Maternal mortality ratio in the context of Maternal mortality rate

Maternal death or maternal mortality is defined in slightly different ways by several different health organizations. The World Health Organization (WHO) defines maternal death as the death of a pregnant mother due to complications related to pregnancy, underlying conditions worsened by the pregnancy or management of these conditions. This can occur either while she is pregnant or within six weeks of resolution of the pregnancy. The CDC definition of pregnancy-related deaths extends the period of consideration to include one year from the resolution of the pregnancy. Pregnancy associated death, as defined by the American College of Obstetricians and Gynecologists (ACOG), are all deaths occurring within one year of a pregnancy resolution. Identification of pregnancy associated deaths is important for deciding whether or not the pregnancy was a direct or indirect contributing cause of the death.

There are two main measures used when talking about the rates of maternal mortality in a community or country. These are the maternal mortality ratio and maternal mortality rate, both abbreviated as "MMR". By 2017, the world maternal mortality rate had declined 44% since 1990; however, every day 808 women die from pregnancy or childbirth related causes. According to the United Nations Population Fund (UNFPA) 2017 report, about every 2 minutes a woman dies because of complications due to child birth or pregnancy. For every woman who dies, there are about 20 to 30 women who experience injury, infection, or other birth or pregnancy related complication.

The Maternal Mortality and Morbidity Task Force was started by the Department of State in 2013 to help reduce maternal death in Texas. The task force and DSHS must submit a joint report on the findings of the task force and recommendations to the governor, lieutenant governor, speaker of the House of Representatives, and appropriate committees of the Texas Legislature by September 1 of each even-numbered year, beginning September 1, 2016. The maternal mortality ratio (MMR) for the state of Texas was concluded to be the highest in the developed world in 2016, with the maternal mortality rate (MMRate) of the state surging beyond the poor MMRate of 48 states of the US (excluding California and Texas) at 23.8% to a remarkably high 35.8%.

In the United States the maternal mortality ratio rose during the years 2002-2015. Although improvements in health care facilitated a dramatic decline in maternal mortality worldwide during the 20th century, women still die from complications of pregnancy, though there are significant differences in the top causes per region and income class. Since 1990 the World Health Organization measures both the maternal mortality ratio and the maternal mortality rate. In 1994 the period of measurement for a "maternal-related death" after childbirth was extended from six weeks to a year after the "birth event". The United States is one of the few developed countries for which both of the WHO measurements have gone up and not down. Nationally as well as in Texas, black women have a maternal mortality rate more than twice as high as White women and this disparity gap has increased since 2007, but the causes of this increase were unclear in 2013 and therefore the task force was formed to investigate. The estimated maternal mortality rate (per 100,000 live births) for 48 states and Washington, DC (excluding California and Texas) increased by 26.6%, from 18.8 in 2000 to 23.8 in 2014. California showed a declining trend, whereas Texas had a sudden increase in 2011-2012. The Texas rate had nearly doubled. Although reproductive health and maternal death is significantly different for black women, this is not part of the study conducted by the Boston Black Women's Health Study and the taskforce is the only known body studying this aspect. Since convening in 2013 the task force has produced two reports, in July 2014 and in September 2016.

In 2021, the People's Republic of China ranked 48th out of 191 countries on the United Nations Development Programme's Gender Inequality Index (GII). Among the GII components, China's maternal mortality ratio was 32 out of 100,000 live births. In education 58.7 percent of women age 25 and older had completed secondary education, while the counterpart statistic for men was 71.9 percent. Women's labour power participation rate was 63.9 percent (compared to 78.3 percent for men), and women held 23.6 percent of seats in the National People's Congress. In 2019, China ranked 39 out of the 162 countries surveyed during the year.