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Number of deaths related to or aggravated by pregnancy (excluding accidental or incidental causes) occurring within 42 days of the end of a pregnancy per 100,000 live births
Number of deaths related to or aggravated by pregnancy (excluding accidental or incidental causes) occurring within 42 days of the end of a pregnancy per 100,000 live births
US Value: 19.3
Top State(s): California: 8.4
Bottom State(s): Alabama, Louisiana: 38.7
Definition: Number of deaths related to or aggravated by pregnancy (excluding accidental or incidental causes) occurring within 42 days of the end of a pregnancy per 100,000 live births
Data Source and Years: Federally Available Data, Maternal and Child Health Bureau, Health Resources and Services Administration, 2016-2020
Suggested Citation: America's Health Rankings analysis of Federally Available Data, Maternal and Child Health Bureau, Health Resources and Services Administration, United Health Foundation, AmericasHealthRankings.org, accessed 2023.
The World Health Organization (WHO) defines maternal mortality as “female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy.” The maternal mortality rate in the United States rose steadily from 1990 to 2015, and in 2018 the U.S. had the highest rate of 11 developed countries. Additionally, substantial disparities in maternal mortality persist by race and ethnicity. After March 2020, a substantial increase in maternal deaths was reported, coinciding with the COVID-19 pandemic.
The Centers for Disease Control and Prevention (CDC) monitors pregnancy-related mortality at the national level. Their surveillance expands the follow-up period to within one year of the end of pregnancy and conducts thorough reviews of each death. The leading causes of pregnancy-related deaths are cardiovascular diseases, infection or sepsis, hemorrhage (bleeding), hypertensive disorders (high blood pressure) and other non-cardiovascular medical conditions, including mental health conditions. According to the CDC, cardiovascular conditions account for more than one-third of perinatal mortality. Complications with cesarean deliveries also play a role in maternal mortality. Causes of pregnancy-related deaths vary by race/ethnicity. One study identified the most common causes as:
The prevalence of maternal mortality is higher among:
According to the WHO, the majority of maternal deaths resulting from pregnancy-related complications are preventable. Approximately two-thirds of deaths from pregnancy-related complications could be prevented by improving the quality of medical care. Strategies to reduce and prevent maternal mortality include:
Many factors are likely associated with the increased risk of death among women of color. Efforts to improve access to and quality of care, reduce the prevalence of chronic conditions among women and address structural racism and implicit bias in health and health care may help close the racial and ethnic gap. The CDC provides concrete steps that individuals, health care providers, health systems, communities and states can take to reduce maternal mortality, particularly among Black women disproportionately affected by it.
Reducing the maternal mortality rate is a Healthy People 2030 leading health indicator.
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MacDorman, Marian F., Eugene Declercq, and Marie E. Thoma. 2017. “Trends in Maternal Mortality by Sociodemographic Characteristics and Cause of Death in 27 States and the District of Columbia.” Obstetrics & Gynecology 129 (5): 811–18. https://doi.org/10.1097/AOG.0000000000001968.
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America’s Health Rankings builds on the work of the United Health Foundation to draw attention to public health and better understand the health of various populations. Our platform provides relevant information that policymakers, public health officials, advocates and leaders can use to effect change in their communities.
We have developed detailed analyses on the health of key populations in the country, including women and children, seniors and those who have served in the U.S. Armed Forces, in addition to a deep dive into health disparities across the country.