The Uneven Burden of Maternal Mortality in the U.S.
Published on: August 02, 2022.
2 out of 3
pregnancy-related deaths are preventable
About this Data Insights
The United States has the highest maternal mortality rate among high-income countries, and is the only one where maternal mortality is increasing. In 2020, the maternal mortality rate in the U.S. was 23.8 deaths per 100,000 live births, a 14% increase from the prior year, yet most pregnancy-related deaths are preventable. The rate among Black women is nearly three times that of White women. These racial disparities are linked to structural racism, underlying chronic conditions, disparities in access to health care and many of the social determinants of health.
This infographic highlights the new and existing challenges to providing effective reproductive health care that will reduce racial disparities in maternal mortality, and potential strategies to reduce maternal mortality and morbidity nationwide.
We recognize that not all people who become pregnant or give birth identify as women. We incorporate gender-inclusive language in our work and use the terms “woman,” “women,” and “maternal” to be consistent with the language used in the research cited here
Reproductive health and maternal health encompasses: American Civil Liberties Union, Why We Use Inclusive Language to Talk About Abortion, June 2022
What does maternal mortality mean in the US?
What does maternal mortality mean in the US: The Commonwealth Fund, Maternal Mortality in the United States: A Primer, December 2020
Maternal mortality ratio
Pregnancy-related mortality in the United States: Centers for Disease Control and Prevention (CDC), Reproductive Health: Pregnancy Mortality Surveillance System, April 2022
NOTE: The graph above shows trends in pregnancy-related mortality ratios between 1987 and 2017 (the latest available year of data)
Highest maternal mortality: The Commonwealth Fund, Maternal Mortality and Maternity Care in the United States Compared to 10 Other Developed Countries, November 2020
Maternal mortality increasing: National Public Radio (NPR), U.S. Has The Worst Rate Of Maternal Deaths In The Developed World, May 2017
When do pregnancy-related deaths occur: The Commonwealth Fund, Maternal Mortality in the United States: A Primer, December 2020
- 31% - Maternal deaths during pregnancy
- 17% - Maternal deaths around time of delivery
- 52% - Postpartum maternal deaths (up to 1 year)
Childbirth is the leading reason for hospitalization of women in the US: Kozhimannil KB, Shippee TP, Adegoke O, Vemig BA. Trends in hospital-based childbirth care: the role of health insurance. Am J Manag Care. 2013;19(4):e125-e132. April 2013
2 out of 3 deaths are preventable: Centers for Disease Control and Prevention (CDC), Pregnancy-Related Deaths in the United States, February 2022
Racial and ethnic disparities continue in maternal mortality
Maternal mortality rate for Black women was about 3x the rate for White women: Hoyert DL. Maternal mortality rates in the United States, 2020. NCHS Health E-Stats. 2022
Maternal mortality by race: Hoyert DL. Maternal mortality rates in the United States, 2020. NCHS Health E-Stats. 2022
NOTE: Data are from the National Vital Statistics System mortality file. Consistent with previous reports, the number of maternal deaths does not include all deaths occurring to pregnant or recently pregnant women, but only those deaths with the underlying cause of death assigned to International Statistical Classification of Diseases
NOTE: Maternal mortality rates are per 100,000 live births based on data from the National Vital Statistics System natality file.
Factors contributing to racial maternal mortality disparities: Centers for Disease Control and Prevention (CDC), Health Equity: Working Together to Reduce Black Maternal Mortality, April 2022
Leading causes of maternal death for Black women: MacDorman MF, Thoma M, Declercq E, and Howell EA. Racial and ethnic disparities in maternal mortality in the United States using enhanced vital records, 2016-2017. American Journal of Public Health DOI: 10.2105/AJPH.2021.306375 (2021)
What happens when access to maternal health care is restricted?
Impacting on reproductive health outcomes: Hawkins, Summer Sherburne et al. “Impact of State-Level Changes on Maternal Mortality: A Population-Based, Quasi-Experimental Study.” American journal of preventive medicine vol. 58, February 2020
How to reduce maternal mortality and morbidity in the US?
Invest in social determinants of health
Invest in social determinants of health & address structural racism: Collier AY, Molina RL. Maternal Mortality in the United States: Updates on Trends, Causes, and Solutions. Neoreviews. 2019
Increase access to alternative perinatal workforce
Benefits of receiving midwifery care: American Pregnancy Association, Midwives, 2021
- Increased satisfaction
- Increases chance at positive breastfeeding
Benefits of receiving midwifery care: Vedam S, Stoll K, MacDorman M, Declercq E, Cramer R, et al. Mapping integration of midwives across the United States: Impact on access, equity, and outcomes. 2018
- Fewer adverse neonatal outcomes
- Reduced racial disparities in maternity care access
- Less obstetric interventions
Diversify the perinatal workforce
Birthing population and workforce: The Commonwealth Fund, Policies for Reducing Maternal Morbidity and Mortality and Enhancing Equity in Maternal Health
NOTE: Original data come from here
Invest in alternative maternal care options
Invest in tele-health: Amritha Bhat et al., “Longitudinal Remote Coaching for Implementation of Perinatal Collaborative Care: A Mixed-Methods Analysis,” Psychiatric Services 71, no. 5, 2020
Invest in black community-based organizations: Julian Z, Robles D, Whetstone S, Perritt JB, Jackson AV, Hardeman RR, Scott KA. Community-informed models of perinatal and reproductive health services provision: A justice-centered paradigm toward equity among Black birthing communities. Semin Perinatol. June 2020
Improve point of care locations for maternal health
Implementing hospital-wide safety bundles: Collier AY, Molina RL. Maternal Mortality in the United States: Updates on Trends, Causes, and Solutions. Neoreviews. 2019
Integrating multidisciplinary care for women: Collier AY, Molina RL. Maternal Mortality in the United States: Updates on Trends, Causes, and Solutions. Neoreviews. 2019
Regionalizing maternal levels of care: Collier AY, Molina RL. Maternal Mortality in the United States: Updates on Trends, Causes, and Solutions. Neoreviews. 2019
Support parents and families before and after birth
Providing patient education on early warning signs for pregnancy complications: Collier AY, Molina RL. Maternal Mortality in the United States: Updates on Trends, Causes, and Solutions. Neoreviews. 2019
Increase access and coverage to postpartum care: American College of Obstetricians and Gynecologists, Extend Postpartum Medicaid Coverage, 2022
Improve paid maternal leave: National Partnership for Women & Families, Paid Leave Is Essential for Healthy Moms and Babies, May 2021
Upcoming Webinar & Briefing
As we enter the third COVID winter, nearly 1 in 3 adults in the US that had COVID-19 also reported experiencing symptoms of long COVID at some point. Emerging research illustrates that long COVID is not just a health problem — it’s an economic one too, disrupting patients’ lives for years to come.