Motherhood should be a time of hope and joy, yet in Nepal, thousands of women still lose their lives during pregnancy, childbirth, or the crucial weeks that follow. Behind every statistic is a real story: a young mother, a grieving family, and a healthcare system that often falls short.
This story, based on data from Maternal Mortality in Nepal, 2021 Census, shines a light on the root causes, revealing how education, geography, and systemic care gaps create unequal and deadly risks for Nepalese mothers.
What Puts Mothers at Risk
Education: A Life Saving Shield
A large share of maternal deaths occurred among women with no formal education, highlighting the strong link between educational attainment and maternal health outcomes. Women who lacked schooling were more vulnerable to complications during pregnancy and childbirth, often due to limited awareness of safe maternity practices and restricted access to health services. In contrast, maternal deaths were significantly lower among women with higher levels of education, such as those holding bachelor’s degrees or above, reflecting the positive influence of education on health-seeking behavior, decision-making power, and timely utilization of maternal care services.
Stages of Risk
Maternal deaths are often classified across three critical stages of motherhood: pregnancy, delivery, and the postpartum period. Each stage carries its own risks, but among them, the postpartum period has proven to be the most dangerous for women in Nepal. According to the National Population and Housing Census 2021, 59.01% of maternal deaths occurred during the postpartum stage, while 35.29% took place during pregnancy, and the remaining 5.7% deaths occurred during delivery.
Age Patterns in Maternal Mortality
Most of the women who lost their lives were within the age group of 20 to 34 years, which represents the prime childbearing period and the most vulnerable age group for maternal deaths. The second highest number of deaths was reported among women aged 35 to 49 years, followed by those between 15 and 19 years. A notable share of deaths also occurred among adolescent mothers, emphasizing the continued risks faced by younger women during pregnancy and childbirth. This pattern highlights the need for strengthened maternal health interventions across all reproductive age groups.
Unequal Burdens Across Nepal
Provincial Disparities
Among Nepal’s provinces, Lumbini recorded the highest number of maternal deaths, closely followed by Madhesh. In contrast, Karnali and Gandaki reported comparatively fewer cases. This uneven distribution reflects how regional disparities in healthcare access and infrastructure continue to shape maternal survival across the country.
Geographic Variation
The Terai region, characterized by its relatively high population density and greater access to healthcare facilities, accounted for the majority of maternal deaths in the country. This indicates that despite better service availability, challenges such as delays in seeking care, inadequate maternal health awareness, and limited quality of services persist in the region. The hill region followed, reflecting similar issues but on a comparatively smaller scale, possibly due to differences in population distribution and accessibility. In contrast, the mountain region reported the lowest number of maternal deaths, which may be attributed to its smaller population size and lower number of recorded pregnancies, though geographic barriers and limited health infrastructure remain significant concerns.
Where the System Falls Short
- Postpartum Neglect: Despite being the deadliest phase, postpartum care receives inadequate attention and resources.
- Unequal Access: High risk provinces remain underserved with limited emergency and follow up services.
- Education Divide: Women lacking education remain disproportionately vulnerable.
- Urban Blind Spots: Postnatal complications in cities often go unnoticed without effective monitoring.
A Path to Safer Motherhood
To turn the tide on maternal mortality, Nepal must:
- Invest in Girls’ Education: Every additional year in school dramatically reduces maternal deaths.
- Strengthen Postnatal Care: Mandate at least three postpartum check-ups with community follow up to catch and treat complications early.
- Bridge Regional Gaps: Allocate more resources and skilled health workers to vulnerable provinces and remote regions.
Maternal mortality in Nepal is more than a health problem it is a story of inequality, geography, and gaps in care. By addressing education disparities, strengthening health systems, and expanding postpartum support, Nepal can save thousands of mothers’ lives. Each life saved echoes far beyond the individual it protects: families, empowers communities, and builds a healthier future for the nation.
Every mother’s survival is a victory worth fighting for.
