en Midwifery Orginal research <div style="text-align: justify;"><span style="line-height:2;"><span style="font-size:14px;"><span style="font-family:Times New Roman;"><b><span style="color:#2980b9;">Background:</span> </b><strong>Abortion</strong> is considered a major public health issue, especially in low- and middle-income countries. There is a lack of recent global trend analyses stratified by Sociodemographic Index (SDI) that comprehensively assess maternal mortality, incidence, and disability-adjusted life years.<br> <b><span style="color:#2980b9;">Objective:</span> </b>This study examines global disparities in maternal mortality, incidence, and disability-adjusted life years (DALYs) related to abortion and miscarriage.<br> <span style="color:#2980b9;"><b>Methods:</b></span>This secondary data analysis utilized the Global Burden of Disease (GBD) 2021 dataset to extract maternal mortality ratios (MMRs), incidence rates, and disability‑adjusted life years (DALYs) related to abortion and miscarriage from 1990 to 2021, all reported with 95% uncertainty intervals (UIs). Analyses were conducted using age‑standardized rates and among women aged 15&ndash;49 years, stratified by Socio‑Demographic Index (SDI) categories. Temporal trends in age‑standardized rates were assessed using Joinpoint Regression Software (version 4.8.0.1).<br> <span style="color:#2980b9;"><b>Results:</b></span> Over the 31‑year period, Joinpoint trend analysis showed a significant global decline in all indicators. DALY rates decreased from 104.39 to 25.73, maternal mortality ratios declined from 36.07 to 12.92, and incidence rates decreased from 1603.84 to 1001.64 per 100,000 population. High‑ and high‑middle‑SDI countries experienced the steepest and most significant declines, whereas low‑SDI countries showed the smallest reductions and continued to bear the highest burden in 2021.<br> <span style="color:#2980b9;"><b>Conclusion: </b></span>Maternal mortality, incidence, and DALY rates related to abortion and miscarriage have substantially declined worldwide. While high and high-middle SDI countries experienced the steepest declines, substantial inequalities persist, with low-SDI countries continuing to bear a disproportionately high burden in 2021. These persistent disparities highlight the need for continued action.</span></span></span><br> &nbsp;</div> Maternal Mortality, Abortion, Disability-Adjusted Life Years, Global Burden of Disease 70 84 http://nmcjournal.zums.ac.ir/browse.php?a_code=A-10-36-2&slc_lang=en&sid=1 Fatemeh Masaebi fatemeh.masaebi71@gmail.com 100319475328460014384 100319475328460014384 No Social Determinants of Health Research Center, Health and Metabolic Diseases Research Institute, Zanjan University of Medical Sciences, Zanjan, Iran Azam Maleki malekia41@yahoo.com 100319475328460014385 100319475328460014385 Yes Social Determinants of Health Research Center, Health and Metabolic Diseases Research Institute, Zanjan University of Medical Sciences, Zanjan, Iran Zohre Farahmandkia zfk200@gmail.com 100319475328460014386 100319475328460014386 No Department of Environmental Health Engineering, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran