On October 25, 2025, Dr. Aderinwale Oluseyi, a seasoned obstetrician and gynaecologist at the Federal Medical Centre in Abeokuta, Ogun State, sounded a clarion call for urgent and sustained action to address Nigeria’s persistently high maternal mortality rate. In a heartfelt phone interview, Dr. Oluseyi—who also serves as a Senior Clinical Researcher at Quillen College of Medicine in the United States—described the country’s maternal health crisis as a stark reflection of deep-rooted health inequities that continue to plague Tropical Africa. His words echoed a sentiment shared by many in the global health community: every maternal death represents a life and a family disrupted, not just another entry in a grim statistical ledger.
According to UNICEF, Nigeria’s maternal mortality rate stands at a staggering 576 per 100,000 live births, making it the fourth highest in the world. The World Health Organization (WHO) has repeatedly underscored that nearly all global maternal deaths occur in developing countries, with more than half in sub-Saharan Africa—a region where Nigeria sits at the epicenter of this ongoing tragedy. Dr. Oluseyi emphasized, “Nigeria alone contributes approximately 28.5 percent of all maternal deaths globally.”
These shocking numbers are not mere abstractions. As Dr. Oluseyi poignantly put it, “When we speak of maternal mortality, we are not speaking of a statistic; we are speaking of a woman, a teacher, a Chief Executive Officer, a mother, a daughter with a name, a story, and a future she dreamt of. We are speaking of the silent emptiness in a home where her laughter once resided.”
In 2024, in response to mounting pressure and international scrutiny, the Nigerian Federal Government launched the Maternal and Neonatal Mortality Reduction Innovation and Initiatives, aiming to combat the crisis head-on. Yet, despite these efforts, the challenge remains daunting. Dr. Oluseyi outlined the widely accepted “three-delays” model to explain the causes of preventable maternal deaths: delay in deciding to seek care, delay in reaching a health facility, and delay in receiving adequate care upon arrival. These delays, he stressed, are often fueled by persistent socioeconomic and health system barriers—obstacles that are as entrenched as they are deadly.
“There are families who do not recognize danger signs. Some communities are hours or days from a functional health centre. Even when a woman finally arrives, she may find no electricity, no skilled staff, and no essential medicines to save her life,” Dr. Oluseyi explained, painting a vivid picture of the everyday realities faced by countless Nigerian women.
But this crisis is not unique to Nigeria. Across the Atlantic, the United States faces its own maternal health reckoning, particularly among Black women and underserved communities. As of October 28, 2025, the Black Maternal Health Federal Policy Collective issued a stark warning: H.R. 1, the budget reconciliation bill, threatens to make a bad situation worse. According to the Collective, the bill will deeply cut Medicaid and Affordable Care Act (ACA) coverage, harming Black pregnant and postpartum people who rely on Medicaid for essential care before, during, and after pregnancy.
The changes proposed by H.R. 1 are sweeping. The bill imposes work requirements on Medicaid enrollees starting in 2027, a move expected to cause coverage loss even for working mothers due to administrative barriers. Medicaid eligibility redeterminations will shift from annually to every six months, and retroactive Medicaid coverage will be slashed from three months to one. Some immigrants—including DACA recipients, TPS holders, and refugees—will lose Medicaid and ACA coverage eligibility altogether.
Further compounding the problem, Medicaid enrollees will be barred from using their insurance at certain reproductive health providers, such as Planned Parenthood, limiting access to abortion care, contraception, STI testing, and cancer screenings. The ACA’s enhanced tax premium credits are set to expire on December 31, 2025, meaning that average out-of-pocket insurance premiums will double starting January 1, 2026. As a result, an estimated 4.8 million ACA marketplace enrollees are expected to lose coverage.
The Congressional Budget Office paints a sobering picture: 1.3 million people will lose coverage and become uninsured by 2026 due to Medicaid cuts, a number projected to balloon to 10 million by 2034. An additional 4.1 million are likely to lose ACA coverage. For Black women—who already face higher rates of pregnancy-related complications, severe maternal morbidities, and negative birth outcomes—these losses could be catastrophic. Coverage loss will disrupt postpartum care, a critical period when complications can still arise, forcing patients to seek emergency care and increasing the risk of missed diagnoses.
Funding cuts may also force states to roll back optional maternal health benefits, such as postpartum coverage for up to one year, midwifery care, and birth doula support. These services have proven to improve maternal health outcomes, but with states tightening their budgets, their future is uncertain. Rural hospitals, community clinics, and reproductive health providers could face closures or cutbacks, worsening so-called “maternity care deserts” and leaving pregnant and postpartum people with fewer options for preventive and emergency care.
Dr. Oluseyi’s recommendations for Nigeria resonate across borders. He called for the adoption of the International Federation of Gynecology and Obstetrics’ recommendations, particularly the strengthening of workforce capacity and investing in midwives. “A qualified and well-supported midwife is the single most effective intervention for preventing maternal deaths. Midwives provide 87 percent of all reproductive and newborn health services. Investing in them is the smartest investment we can make,” he argued. Safe contraception and post-abortion care, he added, are essential to reduce unnecessary deaths: “This is not about ideology. It is about saving lives.”
He also linked maternal survival to the rights and well-being of girls and women, noting, “A girl who completes her education, marries later, and can plan her pregnancies is infinitely more likely to survive childbirth.” Dr. Oluseyi issued a direct challenge to leaders: “The high rate of maternal mortality in Nigeria and Tropical Africa is not an act of God. It is the result of systemic failures we have the power to fix. Every mother deserves the chance to live and raise her child.”
In the United States, the Black Maternal Health Federal Policy Collective recommends that states defend and expand coverage using state-only funds, strengthen healthcare infrastructure, address Medicaid enrollment barriers, and keep the public informed about coverage options. “States must ensure continued health care access for their constituents, who will be vulnerable to rising health care costs, reduced coverage of health care services, and limited access to essential care before, during, and after pregnancy,” the Collective urged.
Both the Nigerian and American experiences underscore a sobering truth: maternal mortality is not an inevitable fate, but a solvable crisis rooted in policy choices, resource allocation, and collective will. Whether through fulfilling the Abuja Declaration’s 15 percent health budget commitment or resisting federal funding cuts that threaten to unravel decades of progress, the path forward demands courage, investment, and accountability. As Dr. Oluseyi concluded, “This is not just a healthcare goal; it is a fundamental human right and a measure of our collective humanity.”
