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There are over 300 000 maternal deaths annually worldwide, of which 99% are in developing countries. The leading causes are shown in Table 2.5.

Table 2.5 Causes of maternal deaths worldwide

Source: Data from Maternal mortality, 2015, World Health Organization. https://data.unicef.org/topic/maternal‐health/maternal‐mortality/

Cause	Percentage (%)
Haemorrhage	27
Sepsis	11
Unsafe abortion	8
Pre‐eclampsia/eclampsia	14
Embolism	3
Other direct causes	10
Indirect causes	28

The underlying problems include: lack of access to contraception, lack of primary care or transport facilities and inadequate equipment and staffing in district hospitals. The United Nations has made the reduction of maternal mortality one of its Millennium Development Goals. The worldwide proportion of births with a trained attendant has risen to 61%, but much remains to be done.

The UK Confidential Enquiries are globally respected as an example of good practice and several countries – for example South Africa, Moldova and Kazakhstan – have set up their own enquiries adapted from the UK model.