While global maternal mortality rates are steadily declining, the World Health Organization (WHO) has shifted its focus from solely reducing deaths during childbirth to a more holistic goal promoting women’s health and “wellbeing” throughout pregnancy and the postpartum period. This shift is reflected in the newly released global definition and conceptual framework for maternal well-being, developed under WHO’s leadership through a multi-year, large-scale, and multi-stakeholder collaborative process.
Maternal mortality rate
Maternal mortality refers to deaths resulting from complications related to pregnancy or childbirth. According to United Nations data, between 2000 and 2023, the maternal mortality ratio (MMR) decreased by 40%, with significant declines observed both globally and regionally. Specifically, maternal mortality dropped by 75% in Eastern Europe and by 71% in South Asia. In 2000, there were 328 maternal deaths per 100,000 live births; by 2023, this number had fallen to 197. However, maternal mortality rates vary significantly between high- and low-income countries. As of 2023, over 90% of maternal deaths occurred in low- and lower-middle-income countries. The lifetime risk of maternal mortality also differs greatly based on a country’s income level. In high-income countries, the average lifetime risk is approximately 1 in 8,000 women, whereas in low-income countries, the risk is substantially higher, around 1 in 66 women.
In Georgia, the maternal mortality rate has significantly decreased over time. In 1985, there were 34 maternal deaths per 100,000 live births, while by 2023, this figure had dropped to 20, an improvement of 14 points. Notably, since 2019, the maternal mortality rate has been consistently declining.
Against the background of the reduction in maternal mortality, the World Health Organization now focuses not only on reducing mortality, but also on improving the quality of life and well-being of mothers. WHO considers “wellbeing” a positive state, which is based on individual and societal experience. Well-being implies quality of life and a person’s ability to contribute to the world. The well-being of a society is defined by its resilience, ability to act, and readiness for change. Well-being is divided into two parts: subjective (personal experience) and objective (assessment of environment and living conditions). However, this general definition does not reflect the specific needs and experiences of women in the period from the beginning of pregnancy to one year after childbirth.
New global priority
To improve the quality of life of mothers and pregnant women, WHO began developing frameworks for “well-being” in 2022, continuing into early 2025, and established a global definition of maternal well-being:
,, A positive state experienced throughout pregnancy and continuing until 1 year after the end of pregnancy, influenced by the world the woman lives in.”
WHO also actively began not only ideological but practical work to improve the quality of life for mothers. Since 2022, the organization has examined the experiences of many women during pregnancy and the postpartum period. In 2023, a parallel meeting was convened to jointly develop a clear, evidence-based definition of maternal well-being. They outlined steps for advancing maternal well-being and integrating it into national programs. The meeting included an interdisciplinary group of global experts, representatives of women’s groups, and partner organizations. The experts represented 15 countries, including high-, middle-, and low-income nations.
In October 2023, WHO presented the maternal well-being project at the XXIV World Congress of Gynecology and Obstetrics (FIGO) to gather feedback and recommendations from clinicians and various stakeholders. According to WHO’s Global Strategy for Women’s, Children’s, and Adolescents’ Health (2016–2030), this new maternal well-being framework: Survival, Thriving, Transforming emphasizes not only the prevention of mortality but also the promotion of positive health and life satisfaction during motherhood, defined as the period from conception to one year postpartum.
In July 2024, the World Health Organization conducted an online survey to review the definition of maternal well-being and its components. The aim of the survey was to identify potential gaps and to evaluate the effectiveness of these definitions in different environments and cultural contexts. The main recommendations following the survey were: the use of globally inclusive language; inclusion of maternal psychological well-being, post-trauma support, and mental health; recognition of diverse families; physical and emotional safety in medical and community settings; support for maternal agency, decision-making, and rights; inclusion of nutrition and education; involvement of fathers and communities; ensuring access to high-quality healthcare and resources; as well as cultural adaptation.
Six components of maternal well-being
The World Health Organization (WHO) framework identifies six interconnected components that reflect the multifaceted nature of maternal well-being. Each includes specific subgroups representing the experiences and needs women face daily during motherhood. These are: health and nutrition; care provision and experience; relationships and connectedness; safety, protection, and stable environment; maternal autonomy; independence and resilience; culture and values.
More than survival
“Survival during childbirth is no longer enough,” reads an article by the World Health Organization. This health policy represents WHO’s first definition and conceptual framework for maternal well-being. WHO has introduced a shift in global health priorities and calls on governments and healthcare systems to recognize women not only as patients but as individuals who need support, empowerment, and respect during one of the most important periods of their lives.
This framework aligns with the Sustainable Development Goals and principles of gender equality and also serves as a foundation for strong families and communities where mothers are empowered not only to give birth safely but also to feel secure during the postpartum period. WHO’s goal by the end of 2030 is to create an environment in which every woman, child, and adolescent, regardless of their geographical or social circumstances, is ensured physical and mental health, well-being, equal social and economic opportunities, and full participation in the development of a sustainable and thriving society.
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