Pregnancy
The 2025 RDHS puts the maternal mortality ratio at 149 deaths per 100,000 live births for the five years before the survey, down from 203 in the 2019-20 survey, a fall the report describes as not statistically significant, the pregnancy-related mortality ratio at 172, and the lifetime risk of maternal death at one in 167 women. Of women with a live birth in the two years before the survey, 95% received antenatal care from a skilled provider, 78% had at least four antenatal visits and 20% had eight or more; 98% of those births took place in a health facility (95% in a public facility, 3% in a private one) and 2% at home, 24% were by caesarean section, and 61% of both mothers and newborns received a postnatal check within two days.
Insurance underpins access: 87% of women and 88% of men aged 15 to 49 have health insurance, up from 83% in 2019-20, and Mutuelle/community health insurance is the most common scheme (82% of women and men); 86% of household members are covered, 94% of the insured through Mutuelle.
Adolescent pregnancy has risen: 8% of women aged 15 to 19 have ever been pregnant, including 6% who have had a live birth and 1% who have had a pregnancy loss, and 2% were pregnant at the time of the survey. The share ranges from 5% in the Northern Province to 12% in the Eastern Province and was 5% in 2019-20. Four percent of women aged 15 to 19 had sexual intercourse before 15 and less than 1% were pregnant before 15. Any sexual act on a person under 18 is the offence of child defilement under art. 133 of the Penal Code, so a pregnancy of a girl under 18 is a matter for the police, as the consent section explains.
The legal framework changed in 2025. Law N° 026/2025 regulating healthcare services, in force since 18 September 2025, lists antenatal, labour and postnatal care and the care of the newborn among reproductive health services (art. 21), gives every person the right to reproductive health without discrimination (art. 57), the right to emergency care and to referral where a facility cannot treat the patient (art. 56) and the right to consent or refuse, a representative deciding for a user under 15 (arts 2, 62 and 63). It repealed Law N° 21/2016 on human reproductive health (art. 110), whose art. 6 gave a pregnant woman, a woman who had given birth and the newborn the right to be cared for and whose art. 15 had the Government set up a reproductive health unit in each hospital and health centre. Article 9 of Law N° 59/2008 forbids firing a woman just because she is pregnant or on maternity leave and states that 'pregnancy and delivery shall not constitute cause for depriving a student of her right to education'.
HIV and pregnancy meet in the survey data: 93% of women and 87% of men aged 15 to 49 know that the risk of mother-to-child transmission of HIV can be reduced if the mother takes special drugs. The HIV page covers testing, treatment and the offences related to HIV.
Key points
| Maternal mortality ratio, five years before the survey | 149 per 100,000 live births (203 in 2019-20); pregnancy-related mortality ratio 172 (RDHS 2025) |
|---|---|
| Lifetime risk of maternal death | 1 in 167 women (RDHS 2025) |
| Antenatal care from a skilled provider | 95%; four or more visits 78%; eight or more 20% (births in the last two years, RDHS 2025) |
| Births in a health facility | 98% (95% public, 3% private); 2% at home; caesarean sections 24% |
| Postnatal check within two days | 68% of mothers, 72% of newborns, 61% for both |
| Women aged 15 to 19 who have ever been pregnant | 8% (5% in 2019-20); Northern Province 5%, Eastern Province 12% |
| Women aged 15 to 49 with health insurance | 87%; Mutuelle/community insurance 82% (83% any insurance in 2019-20) |
| Pregnant student | Pregnancy and delivery are not a cause for depriving a student of her right to education (Law N° 59/2008 art. 9) |
| Pregnant employee | May not be fired just because she is pregnant or on maternity leave (Law N° 59/2008 art. 9) |
In practice
- Start antenatal care early at a health centre: 78% of recent mothers had at least four visits and 67% began in the first trimester (RDHS 2025), and antenatal, labour and postnatal care are reproductive health services under art. 21 of Law N° 026/2025.
- Ask the provider to explain the risks, benefits and options of each service, which art. 68 of Law N° 026/2025 requires, and remember that the care needs your consent from the age of 15 (art. 62).
- If a school refuses to keep or readmit a pregnant student or student-mother, refer to art. 9 of Law N° 59/2008 and complain to the National Commission for Human Rights, whose mandate covers children's rights (toll-free 3430).
- If the pregnancy follows a sexual act on a girl under 18, report to the Rwanda Investigation Bureau: 3512, 116 for a child, or 3029 for the Isange One Stop Centre.
Cost and coverage
Insurance is the main cost buffer: 87% of women have it, mostly Mutuelle (82%); under Law N° 026/2025 services are paid at prices the Ministry sets by order (art. 40), and no such order was found.
Where to go
- Public hospitals and health centres, where 95% of recent births took place (RDHS 2025).
- National Commission for Human Rights toll-free line 3430, for a school refusing a pregnant student.
- Rwanda Investigation Bureau lines 3512, 116 and 3029.
Worth knowing
The survey reports two different measures, 149 maternal deaths and 172 pregnancy-related deaths per 100,000 live births; they are not interchangeable, and both come from sibling reports in a household survey covering a five-year period.
Frequently asked questions
Can a pregnant student stay in school in Rwanda?
Art. 9 of Law N° 59/2008 states that pregnancy and delivery shall not constitute cause for depriving a student of her right to education.
How many women die from pregnancy and childbirth in Rwanda?
The 2025 RDHS estimates 149 maternal deaths per 100,000 live births for the five years before the survey, against 203 in the 2019-20 survey, and a lifetime risk of one in 167.
Where do most women in Rwanda give birth?
In health facilities: 98% of live births in the two years before the 2025 survey took place in one, 95% in a public facility and 2% at home.
Sources
- Rwanda Demographic and Health Survey 2025 (2025 RDHS) -- Final Report (National Institute of Statistics of Rwanda and Ministry of Health; data collected from 5 June to 25 October 2025) — chapter 9 (maternal and newborn health care), chapter 12 (maternal mortality, change from 203 not statistically significant), chapter 5.8 (teenage pregnancy), section 3.4 (health insurance), chapter 13 (HIV knowledge)
- Rwanda Demographic and Health Survey 2019-20 -- Final Report (National Institute of Statistics of Rwanda, Ministry of Health and The DHS Program, September 2021) — 2019-20 comparison figures: maternal mortality ratio 203, teenage pregnancy 5%
- Law N° 026/2025 of 17/09/2025 regulating healthcare services, Official Gazette Special of 18/09/2025 (trilingual gazette; Ministry of Justice copy) — arts 2, 21, 40, 56, 57, 62, 63, 68 and 110 (repeal of Law N° 21/2016)
- Law N° 21/2016 of 20/05/2016 relating to human reproductive health, Official Gazette n° 23 of 06/06/2016 -- gazette copy published by Laws.Africa — arts 6 and 15 of the repealed 2016 law
- Law N° 59/2008 of 10/09/2008 on prevention and punishment of gender-based violence -- publication copy by Laws.Africa — art. 9: rights of a pregnant woman and of a student
- Law N° 68/2018 of 30/08/2018 determining offences and penalties in general (Penal Code), Official Gazette Special of 27/09/2018 -- gazette copy published by Laws.Africa — arts 2(8) and 133
- Law N° 059/2023 of 04/12/2023 amending Law N° 68/2018 of 30/08/2018 determining offences and penalties in general, Official Gazette Special of 05/12/2023 -- gazette copy archived by Gazettes.Africa — art. 14: art. 133 as rewritten
- National Commission for Human Rights (CNDP) -- 'Human Rights Protection': legal basis, mandate and contacts — mandate and toll-free 3430
- Rwanda Investigation Bureau (RIB) -- contact page: hotlines, headquarters, opening hours — hotlines 3512, 116 and 3029
The general article: Pregnancy · Compare with another country
HIV and AIDS
Law N° 026/2025 regulating healthcare services, in force since 18 September 2025, counts the prevention and treatment of sexually transmitted infections among reproductive health services (art. 21(d)) and sets general rules that cover HIV testing and care: the user consents verbally or in writing before any service, and a representative consents for a person under 15 or with an intellectual disability, mental illness or brain damage (arts 2 and 62); the user may refuse or withdraw consent (art. 63); a facility may treat without consent only where a diagnosed condition endangers the user's life or is likely to compromise the public interest (art. 64); health information is confidential unless the user consents in writing for research or planning, a competent organ asks in writing, or the disease is an epidemic threat (art. 51); and professionals must provide services without any form of discrimination (art. 68(e)). The same law repealed Law N° 21/2016 on human reproductive health (art. 110), whose art. 10 had set out a specific right to a voluntary and secret HIV test and whose art. 13 banned stigmatising people with HIV.
The Rwanda Population-based HIV Impact Assessment, fieldwork October 2018 to March 2019, measured HIV prevalence among people aged 15 to 64 at 3.0%: 2.2% in men and 3.7% in women, about 210,200 adults, 4.8% in urban areas against 2.5% in rural areas, and 4.3% in the City of Kigali (provinces: South 2.9%, West 3.0%, North 2.2%, East 2.9%). Annual incidence among adults was 0.08%, about 5,400 new infections a year. Prevalence was 1.2% in girls and young women aged 15 to 24 against 0.5% in boys and young men. 83.8% of adults living with HIV were aware of their status (85.6% of women, 80.4% of men), 97.5% of those aware were on antiretroviral treatment and 90.1% of those on treatment were virally suppressed; among all adults living with HIV suppression was 76.0%. ICAP at Columbia University published the headline results on 25 September 2019 and the final report is dated September 2020.
The 2025 RDHS, which included blood tests, measured HIV prevalence at 2.2% among people aged 15 to 49: 2.8% in women and 1.5% in men, 3.3% in urban areas against 1.7% in rural areas, 3.7% in the City of Kigali against 1.0% in the Northern Province, and 1.2% among circumcised men against 2.5% among the others. It also found that 77% of women and 71% of men have ever been tested for HIV and received the result, that 45% of women and 55% of men have heard of HIV self-test kits and 6% of each have used one, that 13% of women and 11% of men who have heard of HIV expressed discriminatory attitudes toward people living with HIV, and that 57% of young women and 53% of young men aged 15 to 24 are knowledgeable about HIV prevention.
Criminal law reaches stigma and wilful infection. Article 145 of the 2018 Penal Code punishes anyone who stigmatises a sick person, without intending to protect the sick person or others, with at least one month and less than six months and a fine of FRW 300,000 to 500,000, or one of the two. Article 117, rewritten by art. 9 of Law N° 059/2023, punishes a person who wilfully transmits a disease to another with two to three years and FRW 300,000 to 500,000, and 20 to 25 years and FRW 500,000 to 1,000,000 if the disease is incurable or leaves the person permanently disabled. Article 29 of Law N° 59/2008 separately provides life imprisonment for intentionally transmitting by sexual means a disease that the English text calls 'terminal' and the French text 'incurable', and art. 134 of the Penal Code raises the penalty for rape to life imprisonment when it was committed to infect the victim with an incurable disease.
The National Commission for Human Rights lists people living with HIV/AIDS among the groups whose rights it monitors, and receives complaints at toll-free 3430. After a sexual assault, the UK government's guidance of February 2025 states that HIV post-exposure prophylaxis is free at government hospitals and must be started within 72 hours.
Key points
| HIV test | On the user's verbal or written consent, which can be refused or withdrawn (Law N° 026/2025, arts 62 and 63) |
|---|---|
| Test of a child under 15 or a person unable to consent | Consent of a representative: parent, adult child, spouse, adult sibling, legal custodian or person designated by the facility (arts 2 and 62) |
| Confidentiality | Kept, except written consent for research or planning, written request of a competent organ, or epidemic threat (art. 51) |
| Stigmatising a sick person | 1 to under 6 months and FRW 300,000 to 500,000, or one of the two (Penal Code art. 145) |
| Wilful transmission of a disease | 2 to 3 years and FRW 300,000 to 500,000; incurable or permanently disabling: 20 to 25 years and FRW 500,000 to 1,000,000 (art. 117, Law N° 059/2023) |
| Intentional sexual transmission of an incurable disease | Life imprisonment (Law N° 59/2008 art. 29; 'terminal disease' in the English text, 'maladie incurable' in the French) |
| Adults aged 15 to 64 living with HIV | 3.0%: men 2.2%, women 3.7% (RPHIA 2018-2019) |
| New infections among adults | 0.08% a year, about 5,400 (RPHIA) |
| Aware / on treatment / suppressed | 83.8% of adults living with HIV / 97.5% of those aware / 90.1% of those on treatment (RPHIA) |
| People aged 15 to 49 living with HIV | 2.2%: women 2.8%, men 1.5% (RDHS 2025, blood tests) |
In practice
- Ask for a test at a health facility in your own name from the age of 15: consent is yours to give or refuse (Law N° 026/2025, arts 62 and 63), and the professional must keep your health information confidential (art. 51).
- For a child under 15, a parent or another representative listed in art. 2 of Law N° 026/2025 consents to the test; a young person of 15 or over consents alone.
- After a sexual assault, go to an Isange One Stop Centre (RIB line 3029) quickly: the UK government's guidance says post-exposure prophylaxis is free at government hospitals but only effective within 72 hours.
- If you are stigmatised because of your health condition, report it to the police or to the National Commission for Human Rights (toll-free 3430), citing art. 145 of the Penal Code; discrimination by a health professional breaches art. 68(e) of Law N° 026/2025.
Where to go
- Public hospitals and health centres, which provide the prevention and treatment of sexually transmitted infections among reproductive health services (Law N° 026/2025 art. 21(d)).
- Isange One Stop Centres: RIB line 3029.
- National Commission for Human Rights, KG 201 St, Kigali; toll-free 3430; info@cndp.org.rw.
Worth knowing
Two texts punish intentional transmission differently: life imprisonment for sexual transmission of an incurable disease ('terminal' in the English text) in art. 29 of Law N° 59/2008, and 20 to 25 years for an incurable disease in art. 117 of the Penal Code, rewritten in December 2023; the Penal Code repeals earlier provisions inconsistent with it (art. 334) without naming them, and no court ruling on the point was found.
Frequently asked questions
Is HIV testing compulsory in Rwanda?
No, as a rule: under Law N° 026/2025 every health service requires the user's consent, given from the age of 15, and may be refused (arts 62 and 63); treatment without consent is allowed only where a diagnosed condition endangers the user's life or is likely to compromise the public interest (art. 64).
Is it illegal to discriminate against someone because of HIV?
Art. 145 of the Penal Code punishes stigmatising a sick person with one month to under six months and a fine of FRW 300,000 to 500,000, and Law N° 026/2025 requires health professionals to provide services without any form of discrimination (art. 68(e)); the explicit ban on HIV stigma in the 2016 reproductive health law ended with its repeal in 2025.
How many people in Rwanda live with HIV?
The 2018-2019 HIV Impact Survey found about 210,200 adults aged 15 to 64 living with HIV, a prevalence of 3.0%.
Sources
- Law N° 026/2025 of 17/09/2025 regulating healthcare services, Official Gazette Special of 18/09/2025 (trilingual gazette; Ministry of Justice copy) — arts 2, 21, 51, 62, 63, 64, 68 and 110 (English column; repeal of Law N° 21/2016 in art. 110(c))
- Law N° 21/2016 of 20/05/2016 relating to human reproductive health, Official Gazette n° 23 of 06/06/2016 -- gazette copy published by Laws.Africa — arts 10 and 13 of the repealed 2016 law
- Law N° 68/2018 of 30/08/2018 determining offences and penalties in general (Penal Code), Official Gazette Special of 27/09/2018 -- gazette copy published by Laws.Africa — arts 134 and 145 as published in 2018
- Law N° 059/2023 of 04/12/2023 amending Law N° 68/2018 of 30/08/2018 determining offences and penalties in general, Official Gazette Special of 05/12/2023 -- gazette copy archived by Gazettes.Africa — art. 9: art. 117 as rewritten
- Law N° 59/2008 of 10/09/2008 on prevention and punishment of gender-based violence -- publication copy by Laws.Africa — art. 29: intentional sexual transmission of a 'terminal disease' (English text), 'maladie incurable' (French text)
- Rwanda Population-based HIV Impact Assessment (RPHIA) 2018-2019: Final Report (Rwanda Biomedical Centre and National Institute of Statistics of Rwanda, September 2020) — executive summary: prevalence, incidence, 90-90-90 cascade, provinces; table 6.A
- ICAP at Columbia University, 'Survey Results Put Rwanda on Track to Achieve HIV Epidemic Control' (release of 25 September 2019) — headline results released on 25 September 2019
- Rwanda Demographic and Health Survey 2025 (2025 RDHS) -- Final Report (National Institute of Statistics of Rwanda and Ministry of Health; data collected from 5 June to 25 October 2025) — chapter 13 (HIV knowledge, attitudes, testing) and chapter 14 (HIV prevalence)
- National Commission for Human Rights (CNDP) -- 'Human Rights Protection': legal basis, mandate and contacts — people living with HIV/AIDS among monitored groups; toll-free 3430
- Rwanda Investigation Bureau (RIB) -- contact page: hotlines, headquarters, opening hours — line 3029
- UK Foreign, Commonwealth and Development Office, 'Rwanda: information for victims of rape and sexual assault' (last updated 18 February 2025) — HIV post-exposure prophylaxis free at government hospitals, 72 hours