Kerala’s maternal mortality ratio is now 24

Kerala’s Maternal Mortality Ratio (MMR) as per the latest Special Sample Registration System (SRS) Bulletin 2022-24 stands at 24 (per one lakh live births) and continues to be the state with the lowest MMR in the country. Nationally, the MMR is 87.

This is a drop of six points since the 2021-23 SRS bulletin showed Kerala’s MMR at 30.

Tamil Nadu ranks second with an MMR of 25 and appears to have made significant progress in reducing maternal mortality, with a 10-point drop from 2021-23.

Wide spread

SRS data on MMR, although reported in official documents, has always been at wide variance with the MMR reported by the Department of Health, calculated using the actual numbers in the line list. According to data from the Ministry of Health, the MMR was 28 in 2022-23 and 32 in 2023-24.

Given that 70.8% of child births in the state take place in the private health sector (NSSO data, Round 80), the contribution of private hospitals to the state maintaining its record of lowest MMR should be acknowledged, even as the most serious cases of birth-related complications go to public sector tertiary maternity hospitals.

Since 2017-18, the number of maternal deaths in the state has been on a steady decline, except for 2021-22 when Covid-19 claimed 220 maternal lives. At least for the past few years, the average number of maternal deaths in the state has been hovering around 120-140 annually.

Child births in the state have been falling sharply in the last decade, but the proportion of maternal deaths recorded in the state has not shown such a drastic decline.

High-risk pregnancies

Health officials pointed out that the state is faced with a situation where the number of high-risk pregnancies in the state is also increasing in addition to the common causes of maternal death, postpartum hemorrhage, sepsis and amniotic fluid embolism.

Many gynecologists said the number of women choosing to have children at an older age, pregnant women with multi-morbidities such as diabetes or hypertension and women with heart diseases have increased in the state.

The Kerala Federation of Obstetricians and Gynecologists said some of the causes of maternal deaths they recently identified during the maternal death audit process included serious conditions such as Moyamoya disease, ICSOL (intracranial space-occupying lesion), bacterial meningoencephalitis and massive hemoptysis due to pulmonary TB.

“This change in the maternal profile means that gynecologists will encounter more hidden or unexpected/unexplained maternal complications and the health system will need to focus on improving infrastructure and human resources to better manage obstetric complications,” said a senior health official.

“Kerala had set a target at least a decade ago, based on the UN Sustainable Development Goals, to achieve an MDG of 20 by 2030. There is no room for complacency in the face of changing realities,” he said.

Published – 22 May 2026 20:38 IST