Progress toward the United Nations' Sustainable Development Goals (SDG) for the survival of mothers or babies has slowed, and in some countries—including the United States—maternal mortality rates are on the rise, an annual report from the Bill & Melinda Gates Foundation finds.

The 2023 Goalkeepers Report (51 pages, PDF) is focused on global progress toward the SDG to end all preventable child deaths by 2030 and to cut the maternal mortality rate to fewer than 70 out of every 100,000 births. According to the report, the estimated global maternal mortality rate dropped from 156 deaths per 100,000 live births in 2021 to 151 in 2022. The 2030 projection estimates 138 maternal deaths per 100,000 live births—which is still almost double the SDG target.

The report highlights innovations made within the last 10 years that could save nearly two million lives over the next decade if made accessible to those who need it most. Such innovations include a calibrated obstetric drape to monitor blood loss during childbirth and identify postpartum hemorrhage, IV iron infusions to treat anemia and prevent postpartum hemorrhage, and the use of azithromycin during labor to reduce infection and the risk of sepsis. In the United States, the maternal mortality rate unequally affects Black and Indigenous pregnant people—death rates for Black mothers have doubled since 1999. The cause goes beyond lack of antibiotics or treatment. Rather, it is tied also to the systemic inequities that deny Black and Indigenous women care and put them in danger by simply not being listened to. 

“Of course, these breakthroughs aren’t silver bullets on their own—they require countries to keep recruiting, training, and fairly compensating healthcare workers, especially midwives, and building more resilient health care systems,” Melinda French Gates wrote in an essay for the report. “But together, they can save the lives of thousands of women every year.” 

In Bill Gates’ essay for the report, he focuses on the influx of knowledge that researchers are able to use in prevention and vaccine creation thanks to initiatives like Child Health and Mortality Prevention Surveillance (CHAMPS). Founded by the Gates Foundation, CHAMPS collects blood and tissue samples from children who died to find the root cause of the death and explore ways to prevent similar cases. “Studies like CHAMPS helped us understand that often that first link is malnutrition,” Gates wrote. “Believe it or not, I think this is positive news. Because our growing understanding of why children die has proceeded alongside a second, arguably bigger knowledge boom—this one involving our grasp of nutrition.” 

(Photo credit: Getty Images/kali9)