The Role of Fertility in Maternal Mortality Decline

Paul Stupp, U.S. Centers for Disease Control and Prevention (CDC)
Daniel Williams, U.S. Centers for Disease Control and Prevention (CDC)
Florina I. Serbanescu, U.S. Centers for Disease Control and Prevention (CDC)

The United Nations estimated global maternal deaths declined 34 percent from 546,000 in 1990 to 358,000 in 2008, while the maternal mortality ratio (MMR) declined from 400 to 260 per 100,000. Using this database, we examine the role of fertility in this reduction, and present detailed results for 172 countries. While the global number of women, 15-49, increased from 1.31 to 1.74 billion, annual births were 137 and 136 million. If each country’s population grew as observed, but without changing general fertility rates (GFR) and MMR’s, there would have been 858,000 maternal deaths in 2008. If each country’s GFR changed as observed, but its MMR did not change there would have been 618,000 maternal deaths in 2008. Fertility decline accounts for 48 percent of the difference between the number of maternal deaths under a “no change in GFR and MMR” scenario and the number estimated by the UN for 2008.