The world cut maternal death about 40% since 2000. We read all 194 economies' modeled filings: 16 moved the wrong way — and the only two in the G7 are the United States and Canada

In 2000 the world's governments set a maternal-health target in the Millennium Declaration; in 2015 they renewed it as Sustainable Development Goal 3.1 — cut the global maternal mortality ratio below 70 deaths per 100,000 live births by 2030. The world has moved toward it. On the modeled estimates compiled by the UN's Maternal Mortality Estimation Inter-agency Group — WHO, UNICEF, UNFPA, the World Bank and UN DESA — the global ratio fell from 328 deaths per 100,000 live births in 2000 to 197 in 2023, about a 40% drop, and roughly 260,000 women died of maternal causes in 2023. ^mmodeled We pulled that group's series (World Bank code SH.STA.MMRT, updated July 2026) for every economy carrying a value at both endpoints — 194 in all — and compared 2023 against 2000. In 178 the ratio fell or held level. In 16 it rose. Sort the 16 by wealth and the surprise sits at the top. Seven are high-income economies, and two of those belong to the Group of Seven: the United States, where the modeled ratio rose from 12 to 17, and Canada, from 9 to 12. The other five G7 economies all fell — Japan from 9 to 3, Italy 11 to 6, Germany 7 to 4, the United Kingdom 12 to 8, France 9 to 7. The United States' 17 is now the highest ratio in the bloc, more than double every member except neighboring Canada, and roughly five times Japan's. The direction is not an artifact of our arithmetic. The estimators' own 2025 report, "Trends in maternal mortality 2000 to 2023," names the United States as one of only four countries worldwide with a statistically significant increase since 2000 — Dominican Republic, Jamaica, the United States and Venezuela — the sole G7 economy on that list. ^mmodeled The largest riser anywhere is Venezuela, where the modeled ratio more than doubled, from 86 to 227, across years of economic collapse. ^mmodeled

The following is analysis, not fact. Maternal mortality reads in the public mind as a poverty problem, and in level it still is: the highest 2023 ratios belong to Nigeria (993), Chad (748), and South Sudan and the Central African Republic (692 each) — each dozens of times any wealthy country's. But direction is a different measurement from level, and reading all 194 economies at once separates them. The near-universal decline — 178 of 194 — is a generation of progress. The 16 exceptions are the part a single-country desk structurally cannot see, because the pattern only appears against the full set: the wrong-way movers are not confined to crisis states. They reach the richest bloc on earth. What these data do not tell us is why any one country rose. No cause is isolated here — the ranking is what the record shows, not a mechanism these figures test. That the US and Canada share a continent and a border, and are the two G7 risers, is a fact on the page, not an explanation. ^sspeculative

Two cautions cut against reading the rich-country increases too hard. First, measurement: the United States phased a pregnancy checkbox onto its death certificates between 2003 and 2017, which raised the count of deaths identified as maternal — so part of the recorded US rise reflects better ascertainment, not only more deaths, and comparability over time is genuinely contested. Second, these are modeled estimates with wide uncertainty bands, and the smallest upticks — Canada's three points, Cyprus's two, Greece's one — sit inside that noise. That is why the estimators' significance-tested count is four, not sixteen: of the 16 economies whose ratio rose on the 2000-versus-2023 endpoints, only Dominican Republic, Jamaica, the United States and Venezuela have uncertainty intervals that stay clear of zero. The robust cases — the United States among them — survive both readings.

**View from Washington:** US health agencies attribute much of the measured rise to improved death-certificate coding, and note the national rate has drawn down from its 2021 pandemic peak. ^mmodeled **View from the estimators:** even after any coding adjustment, the United States remains the outlier among wealthy nations — the WHO-led group still flags its trend as a significant, sustained increase against a world moving the other way, and prices its 2023 ratio at roughly triple that of Sweden, Japan, Germany, the UK and France. ^mmodeled