Some 529,000 women die each year in delivery and pregnancy – the over- whelming majority in developing countries. While women in industrialized countries face a 1 in 2,800 chance of dying in pregnancy or delivery, the risk in developing regions is 1 in 61. In sub-Saharan Africa it is as high as 1 in 16. This lifetime risk of death ref lects both pregnancy rates and the qual- ity of delivery care associated with each pregnancy. Maternal deaths occur from both direct and indirect complications. Direct complications account for 80 percent of maternal deaths and include hemorrhage, sepsis, hypertensive disorders from pregnancy,.