Writing Sample · Why Maternal Health Is One of Philanthropy's

Every two minutes, somewhere in the world, a woman dies from complications of pregnancy or childbirth. Most of those deaths are preventable with tools that already exist, cost little, and work. That gap between what we know and what women can actually reach is exactly where philanthropy earns its highest returns.

When a mother survives and stays healthy, her newborn is far more likely to survive, her older children are more likely to stay in school, and her household is less likely to fall into crisis. Few investments compound across a family, a community and a generation the way maternal health does.

The problem: preventable deaths, stalled progress

About 260,000 women died from pregnancy- or childbirth-related causes in 2023, roughly 712 every day, according to the UN's latest joint estimates (WHO). That is a 40% drop since 2000, proof that investment works. But progress has slowed to about 1.5% a year since 2016, and the global ratio of 197 deaths per 100,000 live births is nearly three times the 2030 target of 70 (UNICEF).

The burden is concentrated where health systems are weakest:

Geography. Sub-Saharan Africa accounts for about 70% of maternal deaths (182,000); southern Asia about 17% (43,000).
Income. About 92% of deaths occur in low- and lower-middle-income countries. The ratio in low-income countries is 346 per 100,000 live births, versus 10 in high-income countries.
Fragility. The 37 countries in conflict or institutional fragility account for 61% of maternal deaths, despite having only 25% of the world's births (WHO).

The United States is not exempt. In 2024, the most recent final data, 649 American women died of maternal causes, a rate of 17.9 per 100,000 live births. Black women died at 44.8 per 100,000, about three times the rate for white women (14.2) (CDC/NCHS). The U.S. rate remains one of the highest among wealthy nations (AP), and state review committees judged 85.7% of 2022 pregnancy-related deaths preventable (CDC data via MMHLA).

Reproductive health access sits at the root of all of this. WHO states plainly that preventing unintended pregnancies is vital to avoiding maternal deaths, and its Director-General has called strengthening women's reproductive rights critical. Meanwhile, cuts to humanitarian aid have closed facilities and disrupted supplies for treating hemorrhage and pre-eclampsia, the leading killers. Private donors now carry more weight than they have in decades.

Why it's high-leverage

Maternal health is high-leverage because the solutions are cheap, proven, and compound across generations. Three facts make the case.

The tools are known. The leading causes of maternal death (severe bleeding, infection, pre-eclampsia, delivery complications, unsafe abortion) are preventable or treatable with existing medicines and trained hands. The barrier is reach, not science.
Reproductive health access multiplies every other dollar. Guttmacher's Adding It Up, the latest global edition (2019 estimates), finds that each additional dollar spent on contraception in low- and middle-income countries saves about $3 in pregnancy and newborn care. Meeting both needs together would cut maternal deaths by 62%, for $11 billion less than expanding maternal care alone (Guttmacher).
One life saved protects others. A surviving mother means a newborn more likely to survive, children who stay in school, and a household that avoids catastrophic health costs. The return is measured across a family, not a single patient.

Four places a donor dollar goes furthest

1. Contraception and family planning access

The cheapest maternal death to prevent is the one tied to a pregnancy a woman did not want. WHO calls preventing unintended pregnancy vital to avoiding maternal deaths. In low- and middle-income countries, 218 million women who want to avoid pregnancy are not using modern contraception. Meeting that need alone would avert about 70,000 maternal deaths a year, and a full package of sexual and reproductive health care costs about $10.60 per person per year (Guttmacher, Adding It Up 2019).

What your gift funds: a full range of contraceptive methods, trained counselors, supply chains that keep clinics stocked, and youth-friendly services that reach adolescents before a first, high-risk pregnancy.

2. Midwives and skilled birth attendants

Midwives are the backbone of safe birth. The most recent global State of the World's Midwifery report (2021) found that fully resourcing midwife-delivered care by 2035 could avert 67% of maternal deaths, 64% of newborn deaths and 65% of stillbirths, about 4.3 million lives a year. It found the world short 900,000 midwives, a third of the workforce needed (WHO).

What your gift funds: midwifery scholarships and accredited training, salaries and retention in rural posts, mentoring, and the equipment midwives need to practice.

3. Emergency obstetric care and low-cost commodities

Severe bleeding after birth (postpartum hemorrhage) is the world's leading cause of maternal death, and it now has a proven answer. The E-MOTIVE trial paired a calibrated drape costing $1 to $2 with a bundle of treatments given together. Severe bleeding fell 60%, and fewer women died (University of Birmingham). In October 2025, WHO, FIGO and the International Confederation of Midwives made this approach the global standard in new guidelines (WHO). Every step can be delivered by a midwife.

What your gift funds: scaling the E-MOTIVE approach, steady supplies of oxytocin, tranexamic acid and magnesium sulfate for pre-eclampsia, functioning referral and transport, and safe abortion and post-abortion care where it is legal.

4. Postpartum care, continuity and the systems that track it

The danger does not end at delivery. In the latest U.S. review-committee data (2022), mental health conditions, including suicide and overdose, were the leading underlying cause of pregnancy-related deaths at 27.7%. And 37.8% of deaths came six weeks to a year after pregnancy ended (CDC data via MMHLA). This is where doulas, community health workers, home visits and extended postpartum coverage save lives, and where Black and Indigenous mothers face the widest gaps.

What your gift funds: community doula and home-visiting programs, postpartum mental health screening, maternal mortality review committees, and policy advocacy that protects coverage and reproductive health access.

What donors should look for

The strongest maternal health organizations share a few traits. Use these questions when you evaluate a grantee.

Look for	Question to ask	Why it matters
Proven interventions	Is the approach backed by WHO guidance or trial evidence, like E-MOTIVE?	Proven tools turn dollars into lives saved, not experiments.
Integrated reproductive health	Does the program link contraception, prenatal, birth and postpartum care?	Integration delivers the same results at lower total cost.
Outcome data	Do they track maternal deaths, near misses and coverage, not just activities?	Counting women served is not the same as counting lives saved.
Reach into the hardest places	Do they work in fragile, rural or underserved communities?	61% of deaths occur in conflict-affected or fragile settings; that is where marginal dollars count most.
Local leadership	Are midwives, clinicians and community members leading the work?	Local ownership is what makes gains last after a grant ends.
Health-system strengthening	Do they build public capacity (staff, supply chains, referral) rather than parallel systems?	Systems outlast projects.
Equity focus	Do they measure and close gaps by race, income and geography?	In the U.S., Black women die at three times the white rate.
Flexible funding welcome	Can they use unrestricted or multi-year support?	Aid cuts have left gaps; flexible money fills the most urgent ones first.

A practical tip: ask for the organization's cost per outcome (per birth safely attended, per woman reached with contraception, per facility equipped). Strong groups know these numbers.

The moment for philanthropy

The world cut maternal deaths by 40% in a generation. That progress was bought with exactly the investments described here, and it is now at risk as public aid shrinks. Philanthropy can hold the line and push it forward.

A gift to maternal health and reproductive health access is a bet on proven tools, delivered by trained hands, reaching women who would otherwise go without. Few causes offer donors such clear evidence, such low cost per life, and such lasting returns for families. The question is not whether we know how to save these mothers. It is whether we will fund it.