Maternal mortality rate

Also called: MMR, Maternal mortality ratio · Topic: Measuring Development: Income, HDI and Sustainability · NCERT: Class 11, Ch 8 "Comparative Development Experiences of India and its Neighbours"

Meaning

The Maternal Mortality Ratio (MMR) is the number of women who die from pregnancy-related causes for every 1,00,000 live births. A maternal death means a woman dies while pregnant, or within 42 days after the pregnancy ends, from a cause linked to the pregnancy.

Formula: MMR = (maternal deaths ÷ live births) × 1,00,000

MMR shows whether a woman can get safe care during pregnancy and childbirth. So it is one of the clearest tests of a health system, and of how a society treats its women.

Explanation

How the ratio is built

• Numerator: maternal deaths in a period.
• Only deaths caused by pregnancy count. These happen during pregnancy or within 42 days after it ends.

• A pregnant woman who dies in a road accident is not counted.

• Denominator: live births in the same period, not the whole population.

• Scale: it is given per 1,00,000 (one lakh) live births. Maternal deaths are much rarer than infant deaths, which are counted per 1,000.
• Worked example:
• A state has 10 lakh live births and 930 maternal deaths in a year.
• MMR = 930 ÷ 10,00,000 × 1,00,000 = 93.
• This is India's SRS level for 2019-21 [2].

Ratio versus rate: the two measures

• Maternal Mortality Ratio: deaths per 1,00,000 live births.

• It shows the risk in each pregnancy.

• Maternal Mortality Rate: deaths measured against women aged 15–49 (the reproductive age group).

• It shows two things together: the risk in each pregnancy, and how often women become pregnant.

• Suppose women have fewer children but each birth is just as risky. Then the rate falls while the ratio stays the same.

• Exam point: a figure given "per lakh live births" is always the ratio. NCERT keec108 calls it "Maternal Mortality Rate per lakh births". That label is wrong.

What makes MMR rise or fall

• Institutional deliveries (births in a hospital or health centre):
• A trained person is present at the birth.
• → Heavy bleeding and other emergencies are handled quickly.

• → Fewer mothers die.

• Nutrition and anaemia (too little haemoglobin in the blood):

• An anaemic mother is weaker and copes badly with blood loss at birth.

• In NFHS-5 Phase I, anaemia among pregnant women rose in half of the 22 States/UTs surveyed, even though more women took iron-folic acid (IFA) tablets [5].

• Female literacy and status:

• Educated women are more likely to seek care early.

• Where women are treated unequally, their health gets less attention.

• Evidence from history:

• In 1951, Indian men lived longer than women (37.2 vs 36.2 years).
• Women usually outlive men, so this reversal pointed to gender discrimination and high maternal deaths.
• By 2018-22, women's life expectancy was ahead (71.4 vs 68.6 years).

In India

• Who measures it:
• Sample Registration System (SRS): a large sample survey of births and deaths run by the Registrar General of India. It is India's own official source.

• UN Maternal Mortality Estimation Inter-agency Group (UN-MMEIG): gives modelled estimates, so it is a different source from SRS.

• SRS trend:

• 130 (2014-16) → 97 (2018-20) [3]
• → 93 (2019-21), a fall of 37 points [2].

• India's MMR is now below 100 on SRS data. Check for a newer SRS bulletin.

• UN-MMEIG trend:

• 384 (2000) → 103 (2020) [4].
• Its 2000-2023 report (published 7 April 2025) shows a fall of 23 points from 2020 to 2023 [2], which puts India at about 80.

• 1990 to 2023: India's MMR fell 86%, while the world's fell 48% [2].

• Targets:

• National Health Policy 2017: MMR of 100 by 2020. India met this target.

• SDG target 3.1: global MMR below 70 by 2030.

• Neighbours (keec108, 2017-2023 data): India 103, China 23, Pakistan 154.

• Newer data: PIB has reported NFHS-6 findings on maternal health [6]. Check the figures before you use them.

Don't confuse with

• Maternal Mortality Rate: its denominator is women aged 15–49, not live births. So it also reflects how often women give birth.
• Infant Mortality Rate (IMR): babies who die before their first birthday per 1,000 live births. It counts babies, not mothers, and uses a 1,000 base, not a lakh.
• Neonatal Mortality Rate (NMR): baby deaths in the first 28 days of life. The 42-day window belongs to maternal deaths. The 28-day window belongs to newborns.
• Crude death rate (CDR): all deaths per 1,000 population. It covers everyone, not only mothers or infants.

Prelims Hooks

• MMR = maternal deaths per 1,00,000 live births. A maternal death happens during pregnancy or within 42 days after it ends.
• Trap: a figure "per lakh live births" is the ratio. The rate uses women aged 15–49 as the denominator. NCERT keec108 mislabels it.
• SRS MMR: 130 (2014-16) → 97 (2018-20) → 93 (2019-21) [2].
• UN-MMEIG estimate for India: 384 (2000) → 103 (2020) [4]. It is a different source from SRS, so always name the source.
• SDG 3.1: global MMR below 70 by 2030. NHP 2017: 100 by 2020, which India met.
• 1990–2023: India's MMR fell 86%, while the world's fell 48% [2].

Mains Points

• Growth is not enough: income can rise while mothers keep dying. MMR falls through public action: institutional deliveries, trained staff, nutrition and female education. This is Amartya Sen's capability view (development means expanding what people can actually do and be), and the HDI is built on this idea (GS-II health, GS-III inclusive growth).
• Know the data: SRS (survey-based) and UN-MMEIG (modelled) give different MMRs for the same year. The ratio and the rate measure different things. Good policy needs consistent, correctly defined indicators.
• The last mile to SDG 3.1: India beat its NHP 2017 target, but reaching below 70 needs better care quality, not just more deliveries in facilities. For example, anaemia among pregnant women rose in half the NFHS-5 Phase I States/UTs despite wider IFA coverage [5]. That calls for a move from counting services to improving nutrition quality and maternal care.

Related concepts

• Infant Mortality Rate
• Life expectancy
• Mortality rate
• Undernourishment
• Body Mass Index
• Access to sanitation and drinking water

Read more

• Health and nutrition indicators: reading the numbers