GENEVA (Reuters) – More than half a million women still die each year in pregnancy and childbirth, often bleeding to death because no emergency obstetrical care is available, the United Nations Children's Fund (UNICEF) said last week. Despite modest progress, particularly in Asia, the global maternal mortality toll remains stubbornly stable due to a lack of financial resources and political will, it said. More than 99 percent of the estimated 536,000 maternal deaths worldwide in 2005 occurred in developing countries, half of them in sub-Saharan Africa, it said in a report entitled "Progress for Children: A Report Card on Maternal Maternity".

"One of the critical bottlenecks has always been access to highly skilled health workers required to deliver emergency obstetrical care, particularly Caesarian sections," Peter Salama UNICEF's chief of health, told a news briefing.

Around 50 million births in the developing world, or about four in 10 of all births worldwide, are not attended by trained personnel, according to the report. Haemorrhaging is the leading cause of maternal death in Africa and Asia, causing one in three deaths, it said. Infections, hypertensive disorders, complications of abortion, obstructed labour or HIV/AIDS are other causes. Such complications can be easily treated in a health system whose facilities are staffed with skilled personnel to handle emergencies around the clock, but disparities persist, it said.

"The lifetime risk of maternal death in the developing world as a whole is one in 76, compared with 1 in 8,000 in the industrialised world," UNICEF said.

The riskiest place to give birth is Niger, where the risk of dying in pregnancy or childbirth over the course of a woman's lifetime is one in seven, it said. In Sierra Leone it is one in eight.

But developing countries including Sri Lanka and Mozambique have succeeded in reducing maternal mortality rates, it said. A combination of family planning, training skilled birth attendants, emergency obstetrical care and post-natal care is the key to reducing maternal mortality, according to the agency. At the current average reduction rate of less than one percent a year, the world will miss the goal of reducing maternal mortality rates by 75 percent between 1990 and 2015, to less than 150,000.