Liberia Faces 323 Additional Maternal Deaths Annually as US$2.4 Million Health Funding Cuts Threaten Reproductive Care – Guttmacher

MONROVIA – Liberia could experience an additional 323 maternal deaths annually, alongside more than 107,600 unintended pregnancies and 37,800 unsafe abortions, if reductions in United States and Swedish funding for family planning and sexual and reproductive health services continue, according to a new report by the Guttmacher Institute.

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By Gerald C. Koinyeneh

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The report, titled “More Than Just the Numbers: How Funding Cuts Threaten Sexual and Reproductive Health in Liberia,” warns that the country has lost at least US$2.4 million in family planning and sexual and reproductive health and rights (SRHR) support since 2025, leaving hundreds of thousands of women and couples at risk of losing access to contraception and other essential reproductive health services.

Released in November 2026, the assessment projects that approximately 327,700 women and couples in Liberia could lose access to contraception annually if the funding reductions persist.

The projected consequences include increased unintended pregnancies, unsafe abortions and preventable maternal deaths, placing additional pressure on an already challenged healthcare system.

According to Guttmacher, the loss of external assistance follows the abrupt reduction of United States health support in early 2025 and Sweden’s subsequent decision to wind down its development assistance to Liberia.

The report indicates that US family planning disbursements to Liberia declined by 34 percent following the withdrawal of American assistance, with support for 2026 expected to fall close to zero.

Sweden, identified as Liberia’s second-largest development partner after the United States, announced in December 2025 that it would phase out its development assistance to the country.

That decision brought an end to its 2021–2025 cooperation strategy with Liberia, which involved approximately 1.85 billion Swedish kronor, equivalent to about US$197 million, across 39 projects, including programs supporting reproductive health, gender equality and youth empowerment.

Teenage Girls Face Growing Risks

The report identifies adolescent girls as among the populations most vulnerable to the funding reductions, warning that existing barriers to contraception could worsen as youth-friendly services, community outreach and free contraceptive distribution lose financial support.

Before the funding cuts, more than half of adolescent girls in Liberia who wanted to avoid pregnancy were not using modern contraception, according to 2024 estimates cited by Guttmacher.

Adolescent girls also accounted for 28 percent of unintended pregnancies nationwide during the same year.

If the US and Swedish funding reductions continue, the report estimates that Liberia could record approximately 22,400 additional unintended pregnancies among adolescent girls annually, representing a 62 percent increase over the 2024 baseline.

The institute further projects 9,300 additional unsafe abortions among adolescent girls each year.

Guttmacher warns that these outcomes could undermine girls’ education, employment prospects and their ability to contribute to the country’s long-term development.

It argues that the loss of reproductive health services does not only threaten the immediate health of young women but could also deepen social and economic inequalities.

Unsafe Abortions Could Increase Healthcare Costs

Beyond the human consequences, the report warns that reduced access to contraception could significantly increase the financial burden on Liberia’s healthcare system.

Before the funding reductions, an estimated 131,500 unintended pregnancies occurred annually among women aged 15–49 in Liberia, with approximately 54,500 ending in abortions.

Of those abortions, only about 15 percent were considered safe.

The report estimates that approximately 18,700 women required postabortion care annually, costing the health system nearly US$976,000. The overall cost of abortion-related care, including safe abortion services and treatment of complications, was approximately US$1.02 million.

However, if the funding cuts continue, the number of women requiring postabortion care could rise to approximately 34,000 annually, an 82 percent increase.

The annual cost of abortion-related care could consequently reach US$1.85 million, representing an additional US$833,500 in healthcare expenditure.

Guttmacher estimates that continued funding reductions could result in 37,800 additional unsafe abortions and 6,800 additional safe abortions annually, bringing the total number of abortions to approximately 99,100.

The report further explains that every 1,000 additional unsafe abortions could result in approximately 400 women requiring postabortion care, costing the health system about US$20,900.

It argues that preventing unintended pregnancies through improved access to contraception would be less costly than treating complications arising from unsafe abortions.

The institute estimates that ensuring all abortions are safe, rather than maintaining the current legal restrictions, could reduce annual abortion-related healthcare expenditure by approximately US$1.19 million compared with the projected cost under the current law following the funding cuts.

Public Health Bill Remains Stalled

The funding crisis is unfolding alongside uncertainty over Liberia’s domestic policy framework for sexual and reproductive health and rights.

The report notes that the Public Health Bill, passed by the House of Representatives in 2022, remains stalled in the Liberian Senate.

The proposed legislation seeks to modernize the country’s public health framework, expand access to safe abortion care up to 18 weeks of pregnancy and promote comprehensive sexuality education.

However, provisions relating to sexual and reproductive health and rights have faced pressure for removal, according to the report.

Guttmacher warns that weakening these provisions could further restrict access to essential reproductive healthcare at a time when external funding for such services is declining.

The institute maintains that the combination of reduced donor assistance and uncertainty surrounding domestic policy protections could reverse progress in improving reproductive health outcomes.

Guttmacher Calls for Urgent Government Intervention

Against this backdrop, Guttmacher is urging the Liberian government to take immediate steps to protect access to sexual and reproductive healthcare, particularly for women, adolescent girls and vulnerable communities.

Among its recommendations is the integration of sexual and reproductive health services across public health facilities, nongovernmental organizations and donor-supported programs.

The report also calls for greater investment in community health workers and ensuring that they are adequately equipped to provide reproductive healthcare in accordance with national guidelines.

Additionally, it emphasizes the need to prioritize and protect access to high-quality, age-appropriate health education.

The institute argues that investments in contraception and comprehensive sexuality education can help reduce unintended pregnancies, unsafe abortions, HIV infections and other sexually transmitted infections while lowering long-term healthcare costs.

It further links reproductive autonomy and access to sexual and reproductive healthcare to education, economic empowerment and women’s participation in decision-making.

According to the report, these factors are essential to Liberia’s broader economic development and its efforts to achieve the Sustainable Development Goals.

A Broader Development Challenge

Guttmacher cautions that the consequences of the funding reductions extend beyond the health sector, potentially affecting national productivity, household welfare and Liberia’s long-term development objectives.

The projected increase in unintended pregnancies, unsafe abortions, adolescent pregnancies and demand for postabortion care could place additional pressure on government resources while limiting opportunities for women and girls.

The report concludes that protecting reproductive healthcare is not simply a matter of improving health outcomes but also an investment in human development and economic progress.

For Liberia, the challenge is particularly significant as the country confronts declining external assistance and the need to strengthen domestic financing for essential health services.

Without timely intervention, Guttmacher warns, the loss of contraceptive access and other reproductive health services could translate into thousands of additional health complications and hundreds of preventable maternal deaths every year.