KATHMANDU, June 1: In Nepal, childbirth continues to carry a far greater risk than in developed countries, where maternal deaths are now rare. While advanced nations record fewer than four deaths per 1,000 deliveries, Nepal’s maternal mortality remains alarmingly high.
Experts say the problem is no longer limited to delays in reaching hospitals. Increasingly, concerns are being raised over negligence and poor clinical decisions during treatment itself. Despite government efforts focusing on remote areas, progress has fallen short, and even urban health facilities continue to report worrying outcomes.
In Bagmati Province—home to the federal capital—the situation remains particularly serious, with data indicating up to 151 maternal deaths per 1,000 deliveries. Complications during childbirth, delayed hospital access, and post-delivery complications remain the leading causes.
According to the Nepal Maternal Mortality Study 2021, a striking 72 percent of maternal deaths are linked to surgical deliveries (C-sections). Normal deliveries account for 26 percent, while 2 percent are attributed to medical instruments and procedural complications.
Maternal mortality rate being studied for the first time in Nep...
The study also highlights a growing shift toward surgical births across both public and private health institutions, with the trend especially pronounced in private hospitals and medical colleges.
Obstetrician Dr Laxmi Tamang says the rise in C-sections is being driven not only by medical necessity but also by clinical convenience and financial incentives. “Even when not required, surgical deliveries are increasingly being performed,” she said.
At high-volume maternity centers handling hundreds of deliveries daily, around 39 percent of births are now conducted through C-section. Experts warn that while surgical delivery can be life-saving when necessary, its overuse poses serious risks for both mother and child.
Dr. Tamang also points to international findings, including a Norwegian study that followed 35,000 children born via C-section, where 50 percent were later found to have asthma. She says such long-term impacts remain largely unstudied in Nepal.
Medical experts further caution that babies born through surgical delivery may have weaker immune development. In normal birth, newborns are exposed to beneficial bacteria in the birth canal, which helps strengthen immunity.
Beyond surgical trends, broader data shows structural challenges persist: 40 percent of births still occur at home, 28 percent of cases involve delays in reaching facilities, and 37 percent of deaths are linked to delayed care.
Non-obstetric causes—including gestational diabetes, high blood pressure, postpartum mental health issues, suicide, and unsafe abortions—also contribute significantly to maternal deaths.
Health experts say the figures point to a deeper systemic crisis: over-medicalization of childbirth, weak emergency response, and persistent gaps in maternal healthcare delivery.
