Beyond reproduction: WHO calls for a broader definitions of women's health

Women’s health has historically been viewed primarily through the lens of reproduction, with pregnancy, childbirth and maternal care dominating health policy, research priorities and investment decisions. However, a recent analysis published by the World Health Organization (WHO), which looked at mortality data from across the WHO European Region (the Region), highlights the need for a more inclusive definition of women’s health, one that recognises the health needs, risks and experiences of women across their entire lives.

Women’s health goes beyond maternal health

The WHO describes the decrease in maternal mortality across the Region as a success story, albeit one with limits. Over the past two decades, maternal mortality has generally declined, reflecting improvements in clinical care, surveillance and policy focus. Yet the data also reveals the limits of defining women's health largely by reference to pregnancy and childbirth as most women's deaths occur outside the maternal period. Women are living longer than ever before, but not necessarily in good health, spending more years than men living with chronic illness and disability.

In our previous article on the gender health gap, we discussed how women's health extends beyond reproductive and maternal health to include conditions that disproportionately or differently affect women because of biological, social and environmental factors, a view already supported by existing evidence. The WHO's analysis does not therefore introduce a new concept but its endorsement of this broader definition of women’s health is important: it provides an authoritative framework that can help shape healthcare policy, research funding, innovation and regulatory priorities, supporting efforts to address longstanding gaps in women's health outcomes.

The analysis demonstrates that health systems and data collection practices often mirror societal priorities. As a result, women tend to receive greater attention during their reproductive years, while health issues affecting older women can receive less focus. This imbalance is reflected in research, healthcare delivery and even mortality data. For example, women aged 45 and over are around 14% more likely than men of the same age to have their deaths attributed to "ill-defined" causes, such as frailty, heart failure or unspecified dementia.

Some of this gap is expected, as women are living longer and are more likely to develop multiple chronic conditions as they age, but the WHO suggests this is only part of the story. Women still experience delayed diagnosis, their health conditions/symptoms are less thoroughly investigated and they remain underrepresented in clinical research (particularly in cardiovascular disease). Although it is the leading cause of death for both sexes, cardiovascular disease often presents differently in women compared to men, and may be under-recognised, affecting how women are treated in life and how their deaths are recorded. The result, the WHO warns, is that the true burden of disease is obscured, and women become less visible in the data that shapes decisions.

Importantly, the WHO’s broader definition of women’s health extends beyond traditional healthcare settings. The analysis identifies violence against women as a significant and often under-recognised health issue. It notes that women are more likely to die from violence than from maternal health conditions and that the risk of violence continues throughout the life course, including into older age. The WHO argues that understanding women's health requires consideration of the social, economic and environmental factors that shape health outcomes, not simply biological or reproductive factors.

The implications of this shift are significant. A more inclusive definition of women’s health requires better representation of women in clinical research, greater recognition of sex-specific disease presentation, improved collection of age- and sex-disaggregated health data, and stronger systems for tracking outcomes throughout women's lives. These themes align with wider initiatives being pursued by regulators and policymakers, including the European Medicines Agency's recent focus on improving women's representation in clinical trials and strengthening the evidence base for women's health throughout the medicines lifecycle. 

The legal perspective

For lawyers, regulators and businesses operating in the life sciences and healthcare sectors, this evolving understanding of women's health carries important legal and commercial implications. Organisations involved in the development of medical products can expect closer scrutiny of three key issues: whether women are adequately represented in clinical trials, whether health data is collected and analysed by sex and age, and whether the evidence behind regulatory submissions reflects how conditions affect women (as well as men). At the same time, the wider definition creates opportunities for companies developing medicines, medical devices and digital health technologies to look beyond the traditional focus on reproductive health and consider how their products can meet the needs of women at every stage of life.

More broadly, the growing focus on women's health is likely to influence future policy development, regulatory initiatives and investment priorities. Organisations that proactively address data gaps and adopt a life-course approach to women's health will be better placed to respond to evolving regulatory expectations and growing demand for innovation in this area. Ultimately, the WHO's analysis serves as a reminder that improving women's health requires more than supporting women during pregnancy and motherhood. It requires ensuring that women remain visible in healthcare systems, research, data and policy decisions throughout their lives.