It’s a harrowing journey that’s become all too familiar for women in northeastern Nigeria: the desperate dash to reach life-saving care while the odds are stacked against them. For Aisha Muhammed, that journey began in the third trimester of her pregnancy in April 2025, when she was struck by convulsions and dangerously high blood pressure—a textbook case of eclampsia, one of the world’s leading causes of maternal death, according to the World Health Organization (WHO).
Her village clinic, like so many in this region, stood empty of doctors. The nearest medical help was 40 kilometers away, across some of the world’s most perilous roads. Boko Haram militants, notorious for their 14-year campaign of violence and abductions, now carry out near-daily attacks, turning once-peaceful communities into garrison towns and making travel a gamble with life itself.
Yet, against all odds, Muhammed managed to reach the city of Maiduguri. There, she underwent a cesarean section and delivered twins. The experience, though, left scars deeper than the ones on her body. “Even though children are a source of joy, if I will have to go through the same ordeal again, I am afraid of getting pregnant,” she told the Associated Press, fighting back tears.
Her fear is not unfounded. Nigeria has become the deadliest country in the world for women giving birth. The WHO reported that in 2023 alone, more than 75,000 Nigerian women died from complications related to pregnancy and childbirth—a staggering figure that accounts for over a quarter of all global maternal deaths. In a country of 220 million people, the risk is omnipresent: one in every 100 women dies giving birth.
“If you count five people away, you know a woman who has probably had an issue with maternal morbidity or mortality,” said Jumoke Olatunji, cofounder of the Lagos-based Alabiamo Maternal and Child Wellbeing Foundation, as quoted by the Associated Press. Maternal morbidity, she explained, refers to the health problems that haunt mothers who survive childbirth.
But for the women of Nigeria’s northeast, the numbers don’t even begin to capture the reality. The region faces a perfect storm: a resurgence of Boko Haram violence, a mass exodus of doctors and aid organizations, and the abrupt disappearance of hundreds of millions of dollars in foreign aid from the United States—once Nigeria’s biggest donor.
Roads are now closed by fighting. Many health workers, unable or unwilling to risk their lives, have fled. “There have been times when there were (advertisements) but nobody is willing,” said Dr. Fanya Fwachabe, Borno state sexual and reproductive health manager at the International Rescue Committee, one of the last international aid agencies still operating in the region. Doctors who remain in Borno state can expect to earn between USD 99 and USD 156 a month—a paltry sum given the dangers they face.
The consequences are dire. Aid workers described mothers dying simply because they could not reach care. Some health systems have collapsed outright, and the Borno government admits that insecurity is a major obstacle. “Authorities first need to ensure it is safe for health workers,” Abubakar Kullima, chief medical director at the Borno State Hospitals Management Board, told the Associated Press.
The situation took a dramatic turn for the worse this year, when the Trump administration halted US foreign aid to Nigeria. Between 2020 and 2025, the US Agency for International Development had poured nearly USD 4 billion into the country, with USD 423 million earmarked for maternal health and family planning. With the funding now gone, Nigeria’s government scrambled to fill the gap by releasing an emergency USD 200 million for its health budget. But it’s a far cry from what’s needed, and the government has simultaneously slashed the budget for family planning by almost 97% in 2025.
The world’s attention, meanwhile, has drifted elsewhere. Crises in Ukraine, Gaza, and Sudan have diverted donor priorities, leaving Nigeria’s most vulnerable women to fend for themselves. The US Embassy, when asked by the Associated Press about the funding cuts, did not respond.
The human cost of these compounding crises is heartbreakingly clear in stories like that of Falmata Muhammed. In 2021, she went into labor suddenly in her village of Bulabilin Ngaura. With no hospital nearby, she and her husband set out for Maiduguri—a grueling 57-kilometer journey. But Falmata began bleeding on the way and delivered her child stillborn. The trauma, she said, still weighs heavily on her mind.
Now 30 and pregnant again in 2025, Falmata has moved to Magumeri, a larger town. But even here, hope is thin. The major hospital was burned down in a Boko Haram attack in 2020, and the only medical facility left is a mobile clinic unequipped for childbirth. “The prospects of more health resources have dwindled in the region,” reported the Associated Press.
With so few options, even women who don’t want more children find themselves with little choice. Family planning resources have all but vanished, and the lack of trained personnel, drugs, and open roads during emergencies makes every pregnancy a potential death sentence. When asked what she would want to see if she gets pregnant again, Aisha Muhammed looked down and counted on her fingers: “Hospitals, personnel, drugs and open roads during an emergency. If there are all these, women will not be losing their lives here,” she said.
The broader context is grim. Nigeria’s health systems were already chronically underfunded before these recent shocks. The country’s population—Africa’s largest—puts immense pressure on the few resources that exist. The exodus of doctors and collapse of health infrastructure in the northeast has left entire communities without even the most basic care. Once, international aid helped to fill these gaps. Now, with global crises multiplying, Nigeria finds itself pushed to the bottom of the world’s priority list.
As Boko Haram’s violence continues to flare and the government struggles to keep health services afloat, the future for expectant mothers in northeastern Nigeria looks increasingly bleak. The stories of Aisha and Falmata are not isolated tragedies—they are emblematic of a crisis that touches nearly every family in the region. It’s a crisis that demands not just international attention, but urgent, sustained action to ensure that women no longer have to risk everything just to bring new life into the world.
For now, the women of northeastern Nigeria continue to hope for a day when childbirth is no longer a matter of life and death—a hope that, for many, remains heartbreakingly out of reach.
