Women in Rwanda continue to die from complications during pregnancy and childbirth, with the country recording 149 maternal deaths per 100,000 live births. Severe bleeding after delivery remains the leading cause, according to the Rwanda Biomedical Centre (RBC). Dr François-Régis Cyiza, Head of Maternal and Child Health Programmes at RBC, said the country's long-term goal is to eliminate preventable maternal deaths, but pregnancy-related complications continue to claim mothers' lives. ALSO READ: First Lady says solutions to maternal deaths exist, delivery is the problem Our vision is that no woman should die while giving life, he said. Cyiza said postpartum haemorrhage — severe bleeding after childbirth — is the leading cause of maternal deaths. Other major causes include pregnancy-related hypertension, such as preeclampsia and eclampsia, and infections, particularly those that develop after Caesarean sections. Some women also die because they become pregnant while living with serious underlying conditions such as cancer, liver disease and other chronic illnesses. If these conditions are not well managed before pregnancy, the physiological changes that occur during pregnancy can worsen them and increase the risk of death, he said. ALSO READ: How nationwide OB-GYN skills dev’t is reducing maternal deaths Barriers to safe motherhood Many maternal deaths are preventable, yet they continue to occur for several reasons, according to Immaculée Kantengwa, a midwife at Kibagabaga Level Two Teaching Hospital. She said some women delay seeking medical care because they do not recognise danger signs during pregnancy, are influenced by cultural beliefs, or lack decision-making power within their households. Others struggle to reach health facilities due to poor roads, lack of transport or geographical isolation. There are also challenges in receiving quality care because of shortages of trained health workers, essential supplies such as blood for transfusions and antibiotics, and inadequate emergency obstetric infrastructure, Kantengwa said. She added that poverty, limited education and gender inequality also reduce women's ability to access healthcare and proper nutrition. Early marriage and adolescent pregnancy expose girls and young women to higher biological risks, while conditions such as malaria, anaemia, HIV/AIDS and cardiovascular disease can worsen during pregnancy and contribute to maternal deaths. Efforts to reduce maternal mortality Kantengwa said reducing maternal deaths requires tackling the barriers that prevent women from accessing quality healthcare. Regular antenatal and postnatal care enables health workers to identify and manage complications such as preeclampsia and gestational diabetes early. She stressed that every birth should be attended by a skilled health professional — a midwife, doctor or nurse — trained to manage complications and provide life-saving care. She also called for better-equipped health facilities capable of providing blood transfusions, Caesarean sections and intensive care for mothers and newborns, as well as continued investment in training and retaining midwives and obstetricians, particularly in rural and underserved areas. Access to reproductive health information and contraception, she added, can help prevent unintended pregnancies and enable women to space births, reducing the risk of maternal death. Improving female literacy, delaying the age of first pregnancy and ensuring women have the financial independence to seek healthcare are long-term, high-impact strategies, she said. Progress and targets Rwanda aims to reduce maternal mortality from 149 deaths per 100,000 live births, recorded at the end of 2025, to fewer than 60 deaths per 100,000 live births by 2029. Cyiza said achieving that target would place the country ahead of the Sustainable Development Goal of fewer than 70 maternal deaths per 100,000 live births. We will continue working towards zero preventable maternal deaths, but for now this is the target we have set for the country, he said. Maternal mortality has fallen from 203 to 149 deaths per 100,000 live births over the past five years. Annual maternal deaths have also declined from between 300 and 320 before the end of 2023 to about 270 by June 2025 and around 240 by the end of the following year. Cyiza attributed the progress to expanded antenatal care, an increase in the health workforce and the deployment of more obstetricians and gynaecologists to district hospitals. The recommended eight antenatal care contacts during pregnancy have also contributed to the decline, although many women are still not completing all of them. Only about 28 percent of pregnant women currently complete the eight recommended visits. The Ministry of Health aims to raise that figure to at least 40 percent by 2029. To achieve this, the ministry plans to intensify public awareness campaigns through television, radio and social media to encourage women to attend every antenatal appointment. Community health workers and local government leaders will continue mobilising pregnant women to keep their scheduled visits. Health facilities are also expanding the use of electronic medical records to track women throughout pregnancy. Instead of waiting for women to return on their own, facilities will send appointment reminders by phone. If a woman misses a visit, healthcare providers will contact her to understand the reason, provide guidance and work with community health workers to help her return for care. The aim is to make sure every woman who starts antenatal care is followed throughout her pregnancy so she does not miss the care she needs, Cyiza said.
