- nearly universal free access to maternity care through the Unified Health System however a high rate (50-60%) of c-sections. Also a highly-interventionist private system.

Maternal mortality rate is 67 deaths per 100,000 births.

Perinatal mortality rate is 15.5 per 1,000 births.

Brazil does have midwives, consisting of both traditionally trained midwives (parteiras) in remote areas, particularly the Amazon, and specialized nurse-midwives working in hospital settings. However, the birth system is heavily dominated by physicians, with high C-section rates.

Challenges: an ageing population with young professionals not being replaced. High medical intervention model within urban areas.

Sri Lanka is an island nation in South Asia and has a democratic presidential system, with a population of about 22 million people. Sri Lanka consists of diverse ethnic and religious groups and while the country has strong education and healthcare systems - including maternal health outcomes, women are facing gender inequality with workforce barriers and gender-based violence.

Maternity care in Sri Lanka

Maternity care in Sri Lanka is primarily publicly funded and free through the government health system. Public Health Midwives are most commonly used and available and they provide antenatal, postnatal and community-based care, which includes home visits. Most births occur within the hospital setting with skilled physicians and midwives. Maternity care is generally accessible, however those who are in rural or estate (plantation) communities, have limited access to facilities and specialists than those who are in urban areas. Private maternity care is available, however it is mainly used by the wealthier populations.

Maternal Mortality rate

Sri Lanka's maternal mortality rate has declined from 34 in 2021 to 18 in 2023 per 100,000 births. This is considered low for a developing country, and is one of the best maternal health outcomes in South Asia.

Perinatal Mortality rate

The perinatal mortality rate in Sri Lanka is approx. 15-20 per 1,000 births and includes stillbirths and death within the first week of life. The World Health Organisation reports a neonatal mortality rate of approx. 5 per 1,000 live births, this refers to deaths within the first 28 days.

Main challenges in maternity and women's health

Maternal mental health in Sri Lanka is quite significant but is an under-recognised issue with notable rates of antenatal and postnatal depression. Contributing factors include economic stress, gender inequality and limited mental health services, especially in rural areas. The stigma around mental health often prevents women from seeking care, and maternal health conditions can negatively impact both maternal wellbeing and infant outcomes.

Maternity care in Cambodia is delivered through a mixed public–private health system, but most women rely on the public sector, where midwives form the backbone of maternal and newborn services. Midwives are present in almost all health centres and hospitals, and they provide antenatal care, labour and birth support, and postnatal care. However, the quality and availability of care vary significantly by location. Urban areas, particularly Phnom Penh, have better‑resourced facilities, more skilled staff, and greater access to emergency obstetric care, while rural and remote provinces often face shortages of trained midwives, limited equipment, and long travel distances to referral hospitals. Private maternity services exist but are mostly accessed by wealthier families and are concentrated in cities. As a result, women’s access to safe, continuous maternity care in Cambodia is strongly shaped by geography, socioeconomic status, and the uneven distribution of midwifery resources.

Cambodia’s maternal mortality ratio is estimated at 141 deaths per 100,000 live births, and this burden is closely linked to neonatal outcomes. The neonatal mortality rate is approximately 19 deaths per 1,000 live births, with the highest risk occurring in the first week of life. The leading causes of maternal death include postpartum haemorrhage, hypertensive disorders, sepsis, and complications from unsafe or delayed access to emergency obstetric care. These risks are amplified in rural provinces, where shortages of skilled midwives, limited transport, and under‑resourced facilities delay timely intervention. Compared with neighbouring countries, Cambodia’s MMR remains higher than Vietnam and Thailand but lower than Laos, reflecting both progress and persistent gaps in the quality and accessibility of maternity services.

Maternal and perinatal mortality in Cambodia is driven by a combination of health‑system, socioeconomic and geographic factors. Many women, particularly in rural and remote provinces, face long travel distances, poor roads and limited transport, which delay access to skilled birth attendants and emergency obstetric care. Health centres often lack essential equipment, adequately trained midwives, and the capacity to manage complications such as postpartum haemorrhage, hypertensive disorders, sepsis and birth asphyxia. Socioeconomic barriers—including poverty, low health literacy and out‑of‑pocket costs—further reduce timely care‑seeking. Gender norms and limited reproductive autonomy can delay decision‑making, while high rates of adolescent pregnancy and undernutrition increase clinical risk. Together, these structural and social inequities contribute to preventable maternal deaths, stillbirths and early neonatal mortality across the country.

Cambodia faces several major challenges in maternity care and women’s health, driven by structural, social and health‑system limitations. Rural and remote provinces experience persistent shortages of trained midwives, limited equipment, and weak referral pathways, which delay access to emergency obstetric and newborn care. Many health centres cannot manage complications such as haemorrhage, eclampsia or neonatal asphyxia, contributing to preventable deaths. Women also face financial barriers, out‑of‑pocket costs, and long travel distances that discourage timely care‑seeking. Gender inequality, low reproductive autonomy, and high rates of gender‑based violence further undermine women’s health and decision‑making. Adolescent pregnancy, undernutrition, and gaps in family‑planning access increase clinical risk, while inconsistent quality of care and limited regulation in the private sector create additional inequities. Together, these challenges reflect a health system still developing the capacity, workforce and resources needed to provide safe, equitable maternity care for all Cambodian women.

Brazil is the largest nation in South America. It is also the world's fifth-largest country by area and the seventh-largest by population, with over 213 million people.

Brazil's population structure shows a slightly lower male to female ratio of 0.97 to 1, with a median male age of 35.23 years old and a median female age of 37.25 years old. The highest concentration of adults under 75 years old is in the 41 and 42 year-old age groups, while the lowest concentration is in the 74 and 73 year-old age groups.

Around 90% of the population is either Catholic (65%) or Protestant (22%). In fact, Brazil has the world’s largest Catholic population of 123 million people.

Maternity Care Models

Obstetricians and obstetric nurses represent the health professionals acting in maternity care. These nurses, however, are different to midwives in Australia, as they are not considered an independent professional and operate under doctor supervision.

In Brazil, sociodemographic and health inequalities are a reality that affects development of the country and challenges health managers in a context in which 75% of the population relies on the public health system. Meeting all of the healthcare demands of the population is challenging, mainly because of scarce and limited financial resources.

Brazil has one of the world's highest rates of cesarean deliveries: Some 80 to 90 percent of women in private hospitals in the country give birth via cesarean section. In some hospitals that number climbs to 99 percent.

Maternal Mortality Rate

In recent years, Brazil has had a considerable increase in maternal mortality, especially after the COVID-19 pandemic. Before COVID, in 2019, the maternal death ratio was 57, and in 2020 it increased to 67. In 2021 there were 107 deaths per 100,000 births, with more than 1500 deaths attributable to COVID-19.

Challenges

The difficulties encountered in Brazil are due to several factors but mainly to the lack of resources and attention, leading to many preventable deaths. These are situations that could have been identified during prenatal care, and, especially, in the moments close to birth; those conditions were probably not identified and addressed in a timely manner. This delay in recognizing the serious situation and in treating this condition leads, as a consequence, to maternal death. Maternal deaths are avoidable as long as there is quality care during pregnancy, childbirth, and the postpartum period. It is necessary to have proper investment in the entire health and education system to avoid three delays that could lead to death.

The scenario worsens when eyes turn to Black women, doubly vulnerable. Maternal mortality, especially among Black women, is historical and is part of a set of institutionalised racist practices in the Brazilian health system. For example, in the discrepant form and the delay in the care of Black parturients. In many cases, there is a prejudiced and mistaken belief that Black women are more resistant to pain. Even when they receive care, it is shorter when compared to the time of care for White women in the health system in Brazil (Sistema Único de Saúde). In this way, it is understood the existence of a direct connection between institutional racism and the poor care that is provided to Black parturients.

Nigeria is Africa's most populated nation (rough population of 200 million), and it's no wonder why; Nigeria has the highest birth rate in all of Africa with women giving birth to an average of 6-7 babies and makes up for 40% of babies born in Western and Central Africa. Although the birth rates are so high, the life expectancy of someone living in Nigeria is only 55 years. Nigeria has the highest number of maternal deaths in the world, contributing to 28% in global deaths. According to UNICEF, approximately 262 000 babies die at birth, giving the country the second highest national total, and 257 babies die within their first month - but why? UNICEF states "most died from preventable causes such as premature birth, complications during delivery, and infections like sepsis and pneumonia, a violation of their basic right to survival", and argues the health care in Nigeria must be improved as only one in three babies are delivered into a safe and clean health centre.

There are many contributing factors to Nigeria's high mortality rates in due to mothers being unable to reach care, financial hardship, lack of transportation, insufficient infrastructure and poor literacy levels. UNESCO IICBA points out that many women in Nigeria are giving birth as children, regardless if they've gone through puberty, which puts them at a "greater risk for experiencing poor health outcomes, dropping out of school, living in poverty,[...] intimate partner violence, and they may lack decision-making ability".

Many mothers opt or are forced to utilise a Traditional Birth Attendant (TBA) due to cultural beliefs and lack of access to trained nurses and doctors. Lorette et. al.'s research in 2022 found that some of the reasons Nigerian women (when given the choice) preferred TBAs because of their "perceptions of higher efficacy of traditional medicines; age-long cultural practices; ease of access to TBAs as compared to SBAs; higher costs of services in health facilities; and friendly attitude of TBAs". Their study argues the use of TBAs is contributing to the high mortality rates and suggests replacing them with "skilled birth attendants" instead. They later classify a skilled birth attendant as "a trained nurse, midwife, or medical doctor".