Between 1990 and 2015, there was an incredible 44 percent decrease in global maternal mortality rates. But these impressive gains still fell short of the Millennium Development Goal of reducing the global maternal mortality ratio by three quarters.

One reason is the increasing diversity in causes of poor maternal health, as the easiest and most impactful issues are addressed in many places. Although there has been a reduction in the number of maternal deaths caused by direct complications like hemorrhage, there are a growing number of deaths related to indirect causes and preexisting conditions, like malaria, asthma, and obesity.

Another challenge is what The Lancet, in a new special series, calls “divergence:” major inequities within and across countries that mask pockets of women with very poor access to services and correspondingly poor health indicators.

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