Maternal deaths in Australia 2021–2023

It is important to understand the characteristics of mothers who die, such as their age, number of previous pregnancies (parity), body mass index, whether mothers smoked during pregnancy, and where mothers lived. This information can assist in identifying women at higher risk of maternal death in Australia and inform medical care and service planning.

While particular characteristics may be more commonly found in women who died during pregnancy, such as older or younger age, it cannot be inferred that they are the cause of maternal deaths.

Further, there are relationships between different maternal characteristics and the impact of these on the risk of maternal death can be difficult to assess. For example, parity and maternal age are related - the more pregnancies a woman has had, the more likely she is to have had a previous caesarean section, and the older she is likely to be. Of mothers who died with a parity of 4 or more, all were aged 35 or older, suggesting that more than one factor may influence the pattern of increased risk of maternal deaths with increased parity.

The relationship between different maternal characteristics should be considered when exploring the MMR results for individual maternal characteristics. Data are also presented on each of the maternal characteristics to compare the profile of mothers who die with that of all women giving birth in Australia, to identify characteristics that are over or under-represented among women who died.

Figure 3.2 is an interactive chart exploring maternal deaths by maternal characteristics and classification of death, with number and proportion of deaths and maternal mortality ratios (MMR). Further detailed information on the different risk profiles and rates of maternal death for each characteristic is provided in the sections that follow. Please note that, unless otherwise noted, all proportions are calculated for women with a stated value for that characteristic.

Maternal age at death

Mothers aged under 20 and mothers aged 40 and over have an increased risk of complications and adverse pregnancy outcomes (AIHW 2025). The incidence of maternal death by age group reflects this known risk profile, with mothers aged under 20 and mothers aged 40 and over both over-represented (see Figure 3.2 for all age groups):

• A higher proportion of mothers who died were aged under 20 (5.1%), compared with all women who gave birth (1.6%). 
• A lower proportion of mothers who died were aged 25-29 (12%) compared with all women who gave birth (25%).
• A higher proportion of mothers who died were aged 40 and older (15%) compared with all women who gave birth (4.9%).

When considering the risk of maternal death by age group, note that the average age of mothers in Australia has been consistently rising over time, such that the proportion of mothers in the higher risk age groups is changing. For example, from 2010 to 2023, the proportion of all mothers:

• aged under 20 fell from 3.8% to 1.6%
• aged 20-24 fell from 14% to 9.3%
• aged 35-39 increased from 19% to 23%
• aged 40 and over increased from 4.1% to 5.2% (see Australia’s Mothers and babies for more details).

In 2021–2023, the risk of maternal death was:

• highest for women aged under 20 (MMR 21.5, 3 deaths) and mothers aged 40 and over (MMR 20.9, 9 deaths)
• followed by women aged 35-39 (MMR 7.6, 15 deaths)
• lowest for mothers aged 25-29 (MMR 3.2, 7 deaths) 
• similar for mothers aged 20-24 (MMR 6.0, 5 deaths) and 30-34 (MMR 6.1, 20 deaths).

Numbers for mothers under 20 years should be interpreted with caution, due to the small number of deaths recorded in these age groups in the 2021–2023 triennium (see supplementary table 5 – Data tables: Maternal deaths in Australia, 2021–2023).

To explore maternal deaths by maternal age over a 10-year period, see Maternal deaths in Australia.

Remoteness of usual residence

Remoteness of usual residence can influence the availability of and mothers’ access to health services and supports. The remoteness of usual residence of mothers who died was similar to all women who gave birth, however, some remoteness areas were over-represented or under-represented in 2021–2023:

• A higher proportion of mothers who died lived in Major cities (81%) compared with all women who gave birth (72%).
• A lower proportion of mothers who died lived in Inner regional areas (8%) compared with all women who gave birth (16%).

Mothers who lived in Major cities had the second-highest MMR in 2021–2023 (MMR 7.4, 42 deaths), while the MMR was lower for women living in Inner regional areas (MMR 3.4, 5 deaths) and outer regional areas (MMR 4.1, 3 deaths). Mothers who lived in Remote and very remote areas had the highest MMR (18.3, 2 deaths) however, this ratio should be treated with caution as it is based on very small numbers (Figure 3.2, see supplementary table 10 – Data tables: Maternal deaths in Australia, 2021–2023).

To explore maternal deaths by remoteness of usual residence over a 10-year period, see Maternal deaths in Australia.

Socioeconomic area

Socioeconomic position is a social determinant of health and can have both positive and negative impacts on health equity and outcomes (AIHW 2024a). The socioeconomic areas of usual residence of mothers who died differed somewhat from all women who gave birth in 2021–2023:

• A higher proportion of mothers who died lived in the most disadvantaged areas (33%) compared with all women who gave birth (21%). 
• A higher proportion of mothers who died lived in the least disadvantaged areas (21%) compared with all women who gave birth (17%). 
• A lower proportion of mothers who died lived in the second most disadvantaged areas (5.8%) compared with all women who gave birth (20%).

There was not a clear pattern in the MMR across socioeconomic areas. The highest MMR was seen among women who lived in the most disadvantaged areas (MMR 10.4, 17 deaths), followed by women in the least disadvantaged areas (MMR 8.2, 11 deaths). The MMR across other socioeconomic areas ranged from 2.0 to 6.5 (Figure 3.2, see supplementary table 11 – Data tables: Maternal deaths in Australia, 2021–2023).

Parity

Parity refers to a woman’s number of previous pregnancies carried to a viable gestational age (usually 20 weeks), resulting in live births or stillbirths and excluding the current pregnancy. The parity of mothers who died differed from all women who gave birth in 2021–2023. Mothers with a lower parity were under-represented and mothers with a higher parity were over-represented:

• A lower proportion of mothers who died had no previous pregnancies (38%) or one previous pregnancy (23%), compared with all women who gave birth (44% and 35%, respectively).
• A higher proportion of mothers who died had 3 previous pregnancies (12%) or 4 or more previous pregnancies (13%), compared with all women how gave birth (5% and 3%, respectively).

In terms of the MMR, the rate of maternal death broadly increased with increasing parity. The MMR was lowest in women with no previous pregnancies (MMR 5.1, 20 deaths) or one previous pregnancy (MMR 3.9, 12 deaths). While women with 4 or more previous pregnancies (MMR 25.6, 7 deaths), were almost 5 times more likely to die than women with between 0 and 3 previous pregnancies (MMR 5.2, 45 deaths) (Figure 3.2, see supplementary table 6 – Data tables: Maternal deaths in Australia, 2021–2023). 

To explore maternal deaths by parity over a 10-year period, see Maternal deaths in Australia.

Body mass index

Obesity in pregnancy contributes to increased risks of illness and death for both mother and baby. Pregnant women who are obese have an increased risk of thromboembolism, gestational diabetes, pre-eclampsia, post-partum haemorrhage (bleeding) and wound infections (AIHW 2025). They are also more likely to deliver via caesarean section (AIHW 2025).

Of the 59 maternal deaths, there were 45 women whose body mass index (BMI) was reported. The same BMI categories are used in pregnant and non-pregnant women. A BMI of less than 18.5 is defined as underweight; 18.5 to 24.9 as normal weight; 25 to 29.9 as overweight; and 30 or more as obesity. Obesity can be further classified as BMI of 30.0 to 39.9 (classes I and II) and 40.0 and over (class III) (AIHW 2024b). Increases in BMI are expected during pregnancy.

The BMI profile of mothers who died differed to that of all women who gave birth, with those who were overweight or obese over-represented in 2021–2023:

• A higher proportion of mothers who died were overweight (31%) or obese (33%), compared with all women who gave birth in this period (28% overweight and 24% obese). 

While there was not a clear relationship between BMI and maternal death for the categories of underweight, normal weight and overweight, the MMR was higher for mothers with obesity (MMR 7.4; see Figure 3.2). Importantly however, this increased risk was driven by the higher rate of maternal death in mothers with a BMI of 40 or more (MMR 22), while the MMR for obese mothers with a BMI between 30-39.9 was comparable with other BMI groups (MMR 4.7). These results suggest mothers with the highest class of obesity (class III) are at far greater risk of maternal death.

As the number of maternal deaths with a recorded BMI is limited (24% not stated), caution should be taken when interpreting these data (see supplementary table 7 – Data tables: Maternal deaths in Australia, 2021–2023). 

Smoking during pregnancy

Of the 59 maternal deaths, there were 43 for which information on smoking status was available in 2021–2023. More mothers who died reported having smoked during pregnancy, with 21% (9 mothers) having smoked during the first 20 weeks of pregnancy, compared with 8% of all women who gave birth (see supplementary table 8 – Data tables: Maternal deaths in Australia, 2021–2023). 

Maternal deaths were more common in those who smoked in the first 20 weeks of pregnancy than in those who did not smoke (MMR 12.5 and 3.6 respectively) (Figure 3.2). 

Caution should be taken when interpreting these data, due to the small number of maternal deaths with a recorded smoking status (27% not stated). Further, vaping during pregnancy is an emerging area of concern - see Australia’s Mothers and babies for more detail. The National Maternal Mortality Data Collection and the National Perinatal Data Collection do not currently collect data on the use of e-cigarettes (‘vapes’) during pregnancy, however the AIHW is working with states and territories, through the National Perinatal Data Development Committee, to change this.

To explore maternal deaths by smoking status during pregnancy over a 10-year period, see Maternal deaths in Australia.

Country of birth

In 2021–2023, 40% of mothers who died were born overseas (23 deaths), while 60% (34 deaths) were born in Australia. In comparison, 34% of all women who gave birth were born overseas in 2021–2023, and 66% were born in Australia.

Of mothers who died and were born overseas, most were from Southern and Central Asia (12%, 7 deaths) and New Zealand and Oceania (11%, 6 deaths) (Table 3.1). Where country of birth was stated, the MMR for women who reported being born in another country was higher than that for mothers born in Australia (MMR 7.7 and 5.8, respectively) (Figure 3.2, see supplementary table 12 – Data tables: Maternal deaths in Australia, 2021–2023).

Country of birth is used as a proxy for ethnicity and reflects migration background rather than self-identified ethnic or cultural identity. In isolation, country of birth does not give insight into the unique health system factors that can impact the health and wellbeing of mothers and their babies, such as Medicare eligibility. See Australia’s mothers and babies for more detailed analysis of maternal country of birth for all women giving birth.

(a) Includes North-West Europe and Southern and Eastern Europe.

(b) Includes Sub-Saharan Africa and North Africa.

Notes

1. Maternal deaths include maternal deaths classified as direct, indirect, and those not further classified. In 2021–2023 there were no maternal deaths not further classified. Does not include coincidental deaths, deaths awaiting classification, and late maternal deaths (deaths occurring from 43–365 days postpartum).
2. Data were mapped to the ABS 2016 Standard Australian Classification of Countries (SACC).
3. Data may not add to the total due to rounding.

Source: AIHW analysis of the National Maternal Mortality Data Collection.