Pakistan is one of the countries in South Asia ranking high in maternal mortality rate. Though, a signatory of Agenda 2030, the country still lags behind considerably in achieving Sustainable Development Goals (SDGs). The ratio of maternal mortality is, even higher in rural areas of the country. Lack of health care facilities, education, malnutrition, poverty, high prevalence of violence against women in rural areas, and socioeconomic factors are some of the major contributing elements for elevated levels of maternal mortality and morbidity rate in Pakistan. By making inclusive policies at the national level to improve the reach of the rural population to healthcare facilities, educating women and eliminating gender-based disparities, introducing family planning interventions, accountability, and continuity of democracy are essentially needed to improve maternal health in Pakistan’s rural areas. This chapter focuses on challenges to maternal health in rural areas and possible options to resolve these issues.

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Background: Maternal mortality (MM) is a matter of serious concern in low income developing countries (LDCs). Perspective: A great reduction has been observed regarding the maternal deaths globally after huge efforts since 1990 todate. However, the situation continues to be either stagnant or worsening in developing countries, suggesting that the efforts to cope with this issue are either insufficient or not properly implemented. We need to first diagnose the problem areas that are a great hurdle in the road to success towards the reduction of MM. Postpartum haemorrhage and preeclampsia are one of the most common causes of MM. Malnutrition, neurological dysfunction and cancer are among the non-obstetric causes. Trained medical and paramedical staff can be of great help in this regard by increasing awareness among masses at grass root level. Target set by Millennium Development goal has minimized the MM by 44%. But it has not met the target set by Millenium Development Goals 5 and a lot of measures need to be taken in this regard. Conclusions: Majority of the MDs are preventable and can be avoided by adopting appropriate frameworks, linked data sets, surveillance, birth attendants training, preparation for births, etc. Delay in decision to get healthcare, access to healthcare center and receiving these facilities are the main factors in MM.