title: Reflections on the maternal mortality millennium goal.
abstract: BACKGROUND
  Nearly every 2 minutes, somewhere in the world, a woman dies because of complications of pregnancy and childbirth. Every such death is an overwhelming catastrophe for everyone confronted with it. Most deaths occur in developing countries, especially in Africa and southern Asia, but a significant number also occur in the developed world.
  
  
  METHODS
  We examined the available data on the progress and the challenges to the United Nations' fifth Millennium Development Goal of achieving a 75 percent worldwide reduction in the maternal mortality by 2015 from what it was in 1990.
  
  
  RESULTS
  Some countries, such as Belarus, Egypt, Estonia, Honduras, Iran, Lithuania, Malaysia, Romania, Sri Lanka and Thailand, are likely to meet the target by 2015. Many poor countries with weak health infrastructures and high fertility rates are unlikely to meet the goal. Some, such as Botswana, Cameroon, Chad, Congo, Guyana, Lesotho, Namibia, Somalia, South Africa, Swaziland and Zimbabwe, had worse maternal mortality ratios in 2010 than in 1990, partially because of wars and civil strife. Worldwide, the leading causes of maternal death are still hemorrhage, hypertension, sepsis, obstructed labor, and unsafe abortions, while indirect causes are gaining in importance in developed countries.
  
  
  CONCLUSIONS
  Maternal death is especially distressing if it was potentially preventable. However, as there is no single cause, there is no silver bullet to correct the problem. Many countries also face new challenges as their childbearing population is growing in age and in weight. Much remains to be done to make safe motherhood a reality.
authors.affiliation: John Hunter Hospital, Newcastle, NSW, Australia.
authors.forename: Gerald W
authors.initials: GW
authors.lastname: Lawson
authors.forename: Marc J N C
authors.initials: MJ
authors.lastname: Keirse
mesh_terms: D000028:Abortion, Induced / Q000401:mortality; D002423:Cause of Death / Q000639:trends; D019049:Developed Countries; D003906:Developing Countries; D005260:Female; D014943:Global Health / Q000639:trends*; D006040:Goals; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000401:mortality; D008428:Maternal Mortality / Q000639:trends*; D007744:Obstetric Labor Complications / Q000401:mortality; D010219:Papua New Guinea; D006473:Postpartum Hemorrhage / Q000401:mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality*; D011645:Puerperal Infection / Q000401:mortality; D018805:Sepsis / Q000401:mortality; D013019:South Africa; D006113:United Kingdom; D014480:United Nations; D014481:United States
keywords: Millennium Goals; cesarean section; developing countries; maternal mortality; obesity