This paper examines the ways in which poverty and gender inequality impact maternal mortality by creating barriers to maternal healthcare access and utilization. It also analyzes strategies designed to increase utilization to identify best practices. This paper argues that in order to sustainably reduce MMR and improve the overall life chances of poor mothers, policy and programs need, as a matter of urgency, to address two interrelated, root causes ofmaternal death: poverty, which creates the conditions for inadequate, inaccessible and costly maternal health services in poor and underserved areas, and gender norms that tend to privilege the well-being ofmen and boys at the expense of women and girls, leading to women's lack of economic options and lack of autonomy. The paper reviews evidence that suggests such actions can reduce MMR by increasing acceptability and use of maternal healthcare services, thereby increasing the number ofmothers who receive antenatal and postnatal care and reducing the number of unattended births.