At 2:17 a.m., 27-year-old Amina sat on the edge of a hospital bed in Kaduna, holding her swollen stomach and waiting for the pain to become easier.

She had been in labour for hours.

Her husband had already spent most of their savings getting her to the hospital. The nearest health facility in their community did not have the equipment or staff needed to manage her complications, so they had been referred elsewhere. Now, Amina was waiting again waiting for care, waiting for a safe delivery and, most importantly, waiting to know that she and her baby would make it through the night.

Amina is a fictional character, but her situation reflects a reality faced by many women. For millions of mothers, pregnancy and childbirth are not simply moments of excitement and anticipation. They can also mean navigating financial hardship, long distances to healthcare facilities, inadequate services, lack of skilled personnel, social expectations and, sometimes, life-threatening complications.

This is why understanding mothers' well-being requires us to look beyond pregnancy itself. It requires us to understand the system surrounding the mother.

What Does Maternal Well-being Really Mean?

Maternal well-being refers to the physical, emotional and social well-being of a woman during pregnancy, childbirth and the period after delivery.

A mother's well-being is influenced by much more than whether she receives medical treatment. It is also shaped by whether she can afford care, reach a health facility on time, receive respectful treatment, access skilled healthcare workers and obtain the support she needs after giving birth.

When these systems fail, the consequences can be devastating.

The challenges mothers face

Pregnancy is a natural process, but it can involve serious complications. Conditions such as severe bleeding, high blood pressure disorders, infections and complications during childbirth can become life-threatening without timely and appropriate care.

The World Health Organization estimates that about 260,000 women died during or following pregnancy and childbirth in 2023, with more than 90% of maternal deaths occurring in low- and lower-middle-income countries. WHO also reports that a maternal death occurred approximately every two minutes in 2023.

But maternal mortality is not simply a medical problem because for many women, the problem begins before they ever reach a hospital. A woman may delay seeking care because she cannot afford transportation. Another may live far from a facility capable of handling an emergency. Someone else may lack the freedom or financial resources to make healthcare decisions independently. Even after reaching a facility, shortages of healthcare workers, medicines, equipment or emergency services can create additional delays. These challenges do not affect every woman equally.

Poverty, education, geography and access to healthcare can determine whether a woman receives timely maternal care. Women living in underserved communities can face significantly greater barriers than those living close to well-equipped health facilities. And maternal well-being does not end when a baby is born. The weeks following childbirth are also critical. Mothers can experience physical complications, exhaustion, emotional distress and other challenges while simultaneously being expected to care for a newborn.

A healthy baby matters but so does the woman who gave birth to that baby.

The Role of ICEHD in Maternal and Child Health

Maternal well-being does not end with pregnancy or childbirth. It is closely connected to the health and well-being of the child, making maternal and child health an important part of building healthier families and communities. This is one of the areas of focus of the International Centre for Environmental Health and Development (ICEHD). Through its work in public-health awareness, education and community engagement, ICEHD seeks to bring important health information closer to people and encourage healthier practices among mothers, children and families. Its work in maternal and child health is particularly important because many challenges mothers face can be addressed through early information, prevention, education and access to appropriate care. Educating women and families about antenatal care, safe motherhood, nutrition, breastfeeding, newborn care and the warning signs of pregnancy and childbirth can help people recognize risks and seek help earlier.

Through its maternal and child health activities, ICEHP contributes to raising awareness and encouraging communities to take maternal and child health more seriously because protecting a mother also means protecting her child and supporting a child begins with supporting the mother.

What Does the Research Tell Us?

The numbers help us understand the scale of the problem.

The most recent international maternal mortality estimates, produced jointly by WHO, UNICEF, UNFPA, the World Bank Group and the UN Population Division, cover the period from 2000 to 2023. Globally, the maternal mortality ratio fell from 328 deaths per 100,000 live births in 2000 to 197 in 2023. However, progress has slowed, and the world remains far from the Sustainable Development Goal target of fewer than 70 maternal deaths per 100,000 live births by 2030.

Sub-Saharan Africa carries an especially heavy burden. In 2023, women in the region faced the world's highest lifetime risk of maternal death approximately 1 in 55.

Nigeria's situation remains particularly concerning.

UNICEF's 2024 Situation Analysis of Children and Adolescents in Nigeria, using the then-current international estimates, reported a maternal mortality ratio of 1,047 deaths per 100,000 live births in 2020, corresponding to an estimated 82,000 maternal deaths that year. The report also noted that Nigeria remained far from the SDG target of 70 deaths per 100,000 live births.

Nigeria's own demographic and health data also reveal gaps in access to care. The 2018 Nigeria Demographic and Health Survey reported a maternal mortality ratio of 512 deaths per 100,000 live births for its survey period and found that 43.3% of births were attended by skilled health personnel.

These figures tell us something important: maternal mortality is not an abstract statistic.

Maternal Well-being Is Everyone's Responsibility

Maternal health should not only become a topic when a woman dies during childbirth. Awareness has to begin before pregnancy.

Women and girls need accurate information about reproductive health, pregnancy, nutrition, antenatal care, birth preparedness and postpartum care. Families need to understand the warning signs that require urgent medical attention, partners need to support women in accessing healthcare rather than leaving maternal responsibility entirely to the mother, communities also have a role to play, healthcare workers need the resources and support required to provide quality care. The Governments must continue investing in healthcare facilities, skilled personnel, emergency obstetric services and accessible healthcare financing and policymakers must use reliable data to identify communities where mothers face the greatest risks and society must learn to listen to mothers.

A mother experiencing pain after childbirth should not be told to simply endure it and a pregnant woman who needs medical attention should not have to prove that her suffering is serious enough to deserve care.

The Conversation Must Change

Maternal well-being is not just about keeping a woman alive until she delivers her baby. It is about allowing her to experience pregnancy and motherhood with dignity, safety, support and access to quality care.

Every mother deserves to know where to seek help. Every family deserves access to reliable information. Every healthcare worker deserves the resources to provide lifesaving care. And every community deserves a health system that does not make survival depend on where a woman lives or how much money she has.

The statistics are serious, but they also give us a reason to act.

If maternal deaths can be prevented, then they should be prevented.

If healthcare access can be improved, then it must be improved.

If awareness can help a woman recognize a danger sign and seek care earlier, then that awareness could save a life.

Because maternal well-being is not only about mothers.

It is about families, the children and definitely the communities at large and ultimately, it is about the kind of society we choose to build.

A mother should not have to risk her life to give life.