WHGI Research Area

Maternal Health

Improving care quality, outcomes, and access across the continuum of reproductive and maternal health

WHGI has shown that preventing maternal deaths begins long before delivery, tracing how contraceptive access, quality of care, and policy together shape whether women survive pregnancy and childbirth.

What We Study

The William H. Gates Sr. Institute for Population and Reproductive Health's (WHGI) studies maternal health from family planning through the first year after birth, focusing on preventing maternal complications before they start and strengthening the systems that must respond when they don't.

This work begins upstream, tracing how contraceptive access and improvements in maternity care have jointly shaped maternal mortality trends over the past two decades.

It also follows women forward: Performance Monitoring for Action (PMA) Ethiopia tracked women from pregnancy through the first year postpartum, capturing their own experiences of care and data from the facilities that served them. Facility-based quality assessments turn to the other side of that encounter, asking whether the health system is equipped to recognize and respond when complications arise.

And because prevention operates at the policy level as much as the clinical one, U.S.-based analyses extend the same lens further upstream, examining how state-level abortion restrictions shape maternal and infant mortality. 

Why it Matters

Between 2000 and 2023, maternal deaths worldwide fell by 41%. WHGI research shows that this progress came from two sources, 61.2% is attributable to improved maternity care and 38.8% to family planning. Contraceptive use alone is estimated to have averted 272,000 maternal deaths in a single year. These estimates make the contribution of preventing maternal deaths visible.

The same body of work also shows what stands in the way of improving maternity care. Widely used facility surveys capture only 4 of 31 recommended quality of care indicators related to childbirth, leaving the care women actually receive largely undocumented.

Care can only help women who reach it: economic status, education, and empowerment shape whether women access maternal health services in the first place, a pattern confirmed from data decades apart, from early cross-national research to WHGI's more recent Ethiopia findings.

Access can also be withdrawn: in the United States, WHGI’s WHGI's Dr. Suzanne Bell's research found a 9.2% increase in pregnancy-associated deaths in states that enacted abortion bans, a stark demonstration of what happens when a prevention lever is removed rather than strengthened.

What Comes Next

WHGI seeks to advance its maternal health research around a framework, with particular emphasis on preventing harm and enabling timely rescue before women reach referral facilities.

The work aims to examine how self-care, community characteristics and interventions, and primary-care systems can support rapid initial response, effective referral, and continuity of care across pregnancy and postpartum.

WHGI will pilot and evaluate primary-care models, with the aim of identifying and scaling approaches that make maternal rescue earlier, more equitable, and more reliable. 

Key Resources & Publications in This Area

U
Gender Differences in Sexually Active Life Expectancy in France

Gender Differences in Sexually Active Life Expectancy in France

September 3, 2026
This study enhances population-level indicators of sexual health by broadening the understanding of sexuality beyond partnered behaviors. It reveals significant gender differences in sexual experiences throughout the life course, which lessen when considering sexual quality.
Social Network Involvement in Abortion Care-Seeking and Abortion Outcomes among a Population-Based Sample of Nigerian Women Who Had Abortions

Social Network Involvement in Abortion Care-Seeking and Abortion Outcomes among a Population-Based Sample of Nigerian Women Who Had Abortions

August 14, 2026
Population-based data from Nigeria show that involving both partners and family in abortion care-seeking is linked to safer abortions and fewer repeated attempts.
Infertility service availability, geographic accessibility, and use: results from linked facility-female cross-sectional data in Burkina Faso, Côte d’Ivoire, Niger, and Uganda

Infertility service availability, geographic accessibility, and use: results from linked facility-female cross-sectional data in Burkina Faso, Côte d’Ivoire, Niger, and Uganda

August 4, 2026
Linked facility and survey data across four African countries find infertility services are far less available than STI testing, limiting women's access to care.
Birth certificate measures of maternal morbidity and their limits in abortion policy research

Birth certificate measures of maternal morbidity and their limits in abortion policy research

July 9, 2026
Birth certificate data substantially under- and over-ascertain severe maternal morbidity relative to hospitalization records, raising concerns about their use in evaluating abortion-ban policies.
Impact of The Challenge Initiative on Public-Sector Family Planning Service Provision in Pakistan: Evidence from a Difference-in-Differences Analysis

Impact of The Challenge Initiative on Public-Sector Family Planning Service Provision in Pakistan: Evidence from a Difference-in-Differences Analysis

June 18, 2026
A difference-in-differences analysis finds The Challenge Initiative significantly increased public-sector family planning client volumes across intervention districts in Punjab and Sindh, Pakistan.
Effect of maternity care improvement, fertility decline, and contraceptive use on global maternal mortality reduction between 2000 and 2023: results from a decomposition analysis

Effect of maternity care improvement, fertility decline, and contraceptive use on global maternal mortality reduction between 2000 and 2023: results from a decomposition analysis

May 28, 2026
Analysis suggests that both improved maternity care and fertility reduction, primarily through contraceptive use, substantially reduced maternal mortality globally. Accelerated efforts should be given to maternity care and family planning interventions for achieving the UN's Sustainable Development Goals 3.
Abortion Bans and Maternal, Pregnancy-Related, and Pregnancy-Associated Mortality in 14 US States, 2016–2023: Estimated Impacts Amid Substantial Measurement Challenges

Abortion Bans and Maternal, Pregnancy-Related, and Pregnancy-Associated Mortality in 14 US States, 2016–2023: Estimated Impacts Amid Substantial Measurement Challenges

May 27, 2026
A new study suggests a possible link between US abortion bans and increase in deaths during or within one year of pregnancy. The study, co-led by WHGI faculty member and Associate Professor Suzanne Bell, PhD, MPH, and Alison Gemmill, PhD, MPH, Associate Professor of Epidemiology at the UCLA School of Public Health, analyzed national vital statistics data from 2016 to 2023. Researchers examined trends in maternal, pregnancy-related, and pregnancy-associated mortality across 14 states that had implemented complete or six-week abortion bans by the end of 2022.
PMA, a decade of innovation in family planning data: Voices of the national survey directors

PMA, a decade of innovation in family planning data: Voices of the national survey directors

May 12, 2026
This study assessed lessons learned by country survey directors regarding the implementation of the Performance Monitoring for Action (PMA) household and facility surveys. PMA surveys had rapid turnaround, used a smartphone platform, relied on resident enumerator networks and had annual cadence. Over more than ten years, PMA conducted a total of 85 survey rounds that reached nearly 1 million respondents in 11 countries.
No results found.
See all research publications.

Meet the WHGI Research Team

Saifuddin Ahmed

Saifuddin Ahmed

Professor

Saifuddin Ahmed, MBBS, PhD, is a Professor at the Department of Population, Family and Reproductive Health, with a joint appointment in the Department of Biostatistics. His research interests include improving estimates of maternal mortality and morbidity in resource-poor settings, family planning modeling, and survey design and intervention evaluation.

Saifuddin Ahmed

Professor

Saifuddin Ahmed, MBBS, PhD, is a Professor at the Department of Population, Family and Reproductive Health, with a joint appointment in the Department of Biostatistics. His research interests include improving estimates of maternal mortality and morbidity in resource-poor settings, family planning modeling, and survey design and intervention evaluation.

Suzanne Bell

Suzanne Bell

Assistant Professor

Suzanne Bell, PhD, MPH, is an Assistant Professor in the Department of Population, Family and Reproductive Health at the Johns Hopkins University Bloomberg School of Public Health, where she received her PhD with a focus in demography.

Suzanne Bell

Assistant Professor

Suzanne Bell, PhD, MPH, is an Assistant Professor in the Department of Population, Family and Reproductive Health at the Johns Hopkins University Bloomberg School of Public Health, where she received her PhD with a focus in demography.

Linnea A. Zimmerman

Linnea A. Zimmerman

Principal Investigator | Associate Professor

Dr. Linnea Zimmerman has a PhD from the Department of Population, Family and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health and a Masters in Public Health from Emory University. She has a background in demography and focuses on family planning and women's reproductive health research.

Linnea A. Zimmerman

Principal Investigator | Associate Professor

Dr. Linnea Zimmerman has a PhD from the Department of Population, Family and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health and a Masters in Public Health from Emory University. She has a background in demography and focuses on family planning and women's reproductive health research.

Celia Karp

Celia Karp

Assistant Professor

Celia Karp, PhD, is an Assistant Professor at the Johns Hopkins Bloomberg School of Public Health and a Senior Technical Advisor at the William H. Gates Institute. Her work focuses on reproductive health preferences, services, and outcomes.

Celia Karp

Assistant Professor

Celia Karp, PhD, is an Assistant Professor at the Johns Hopkins Bloomberg School of Public Health and a Senior Technical Advisor at the William H. Gates Institute. Her work focuses on reproductive health preferences, services, and outcomes.

No results found.

By the Numbers

Countries & Territories

WHGI included 195 countries and territories in the global maternal-mortality decomposition analysis. 

Regions of Ethiopia

WHGI has conducted research in six regions of Ethiopia, representing approximately 91% of the population, in the PMA Ethiopia panel.

 News on Maternal Health

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Learn more about WHGI's maternal health work, access available data and publications, or connect with researchers to explore opportunities for collaboration.

Please send an email to gatesinstitute@jhu.edu with the subject line "Research."

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