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Maternal Mortality
Maternal Mortality in Kansas

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Maternal Mortality by State

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

Maternal Mortality Trends

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

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Maternal Mortality

About Maternal Mortality

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,, 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:

  • Cardiovascular and coronary conditions among non-Hispanic Black mothers.
  • Mental health conditions among Hispanic and non-Hispanic white mothers.
  • Hemorrhage among non-Hispanic Asian mothers.
  • Mental health conditions and hemorrhage among American Indian/Alaska Native mothers.

The prevalence of maternal mortality is higher among: 

  • Black and American Indian/Alaska Native women compared with Asian/Pacific Islander, Hispanic and white women.
  • Women without any college education. However, racial and ethnic disparities eclipsed differences in education level, with college-educated Black women still experiencing far higher maternal mortality rates than white and Hispanic women without a high school education.
  • Women ages 40 and older, who have a maternal death rate nearly 16 times that of mothers under 40.
  • Women who live in rural areas compared with those who live in urban areas. Hospital closures in rural areas have decreased access to services such as obstetrics, further contributing to difficulties in maternal care.

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:

  • Preconception health: A healthy pregnancy begins before conception. Improving women’s health across the lifespan and preventing and treating chronic disease may result in healthier pregnancies with fewer complications.
  • Collaboration with midwives and doulas: A study found that incorporating midwives as part of the care team during pregnancy and postpartum recovery is associated with better maternal health outcomes. Areas without nearby hospital services could also benefit from midwifery care. 
  • Medical care improvement: Improvements to hospital protocol and patient safety tools have been effective strategies to reduce maternal mortality. In one study, a collaborative quality improvement program reduced severe maternal morbidity from hemorrhage. Systems to detect early warning signs during prenatal visits may prevent delays in diagnosing and treating conditions that lead to maternal death. The Alliance for Innovation in Maternal Health program offers quality improvement toolkits, maternal early warning systems and other resources to support and guide quality improvement efforts in health care facilities. 
  • Maternal Mortality Review Committees (MMRCs): MMRCs are made up of various medical professionals tasked with identifying and investigating maternal deaths. They attempt to determine the preventability of maternal deaths and recommend focused approaches to prevent future deaths and reduce disparities in maternal mortality. Nearly all U.S. states have MMRCs, and many have established legislation requiring a review of maternal deaths. 

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.

Bailey, Zinzi D., Nancy Krieger, Madina Agénor, Jasmine Graves, Natalia Linos, and Mary T. Bassett. 2017. “Structural Racism and Health Inequities in the USA: Evidence and Interventions.” The Lancet 389 (10077): 1453–63.

GBD 2015 Maternal Mortality Collaborators. 2016. “Global, Regional, and National Levels of Maternal Mortality, 1990-2015: A Systematic Analysis for the Global Burden of Disease Study 2015.” The Lancet 388 (10053): 1775–1812.

Hall, William J., Mimi V. Chapman, Kent M. Lee, Yesenia M. Merino, Tainayah W. Thomas, B. Keith Payne, Eugenia Eng, Steven H. Day, and Tamera Coyne-Beasley. 2015. “Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic Review.” American Journal of Public Health 105 (12): e60–76.

Howell, Elizabeth A. 2018. “Reducing Disparities in Severe Maternal Morbidity and Mortality.” Clinical Obstetrics and Gynecology 61 (2): 387–99.

Hoyert, Donna L. 2021. “Maternal Mortality Rates in the United States, 2019.” Health E-Stats. Hyattsville, MD: National Center for Health Statistics.

Keating, Kim, David Murphey, Sarah Daily, Renee Ryberg, and Jessie Laurore. 2020. “Maternal and Child Health Inequities Emerge Even Before Birth.” The State of Babies Yearbook: 2020. ZERO TO THREE.

Kozhimannil, Katy Backes, Julia D. Interrante, Carrie Henning-Smith, and Lindsay K. Admon. 2019. “Rural-Urban Differences In Severe Maternal Morbidity And Mortality In The US, 2007–15.” Health Affairs 38 (12): 2077–85.

Lassi, Zohra S., Ayesha M. Imam, Sohni V. Dean, and Zulfiqar A. Bhutta. 2014. “Preconception Care: Screening and Management of Chronic Disease and Promoting Psychological Health.” Reproductive Health 11 (S3): S5.

Lu, Michael C., Keisher Highsmith, David de la Cruz, and Hani K. Atrash. 2015. “Putting the ‘M’ Back in the Maternal and Child Health Bureau: Reducing Maternal Mortality and Morbidity.” Maternal and Child Health Journal 19 (7): 1435–39.

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.

Main, Elliott K., Valerie Cape, Anisha Abreo, Julie Vasher, Amanda Woods, Andrew Carpenter, and Jeffrey B. Gould. 2017. “Reduction of Severe Maternal Morbidity from Hemorrhage Using a State Perinatal Quality Collaborative.” American Journal of Obstetrics and Gynecology 216 (3): 298.e1-298.e11.

Mhyre, Jill M., Robyn D'Oria, Afshan B. Hameed, Justin R. Lappen, Sharon L. Holley, Stephen K. Hunter, Robin L. Jones, Jeffrey C. King, and Mary E. D'Alton. 2014. “The Maternal Early Warning Criteria: A Proposal From the National Partnership for Maternal Safety.” Obstetrics & Gynecology 124 (4): 782–86.

Nelson, Daniel B., Michelle H. Moniz, and Matthew M. Davis. 2018. “Population-Level Factors Associated with Maternal Mortality in the United States, 1997–2012.” BMC Public Health 18 (December): 1007.

Petersen, Emily E., Nicole L. Davis, David Goodman, Shanna Cox, Nikki Mayes, Emily Johnston, Carla Syverson, et al. 2019. “Vital Signs: Pregnancy-Related Deaths, United States, 2011–2015, and Strategies for Prevention, 13 States, 2013–2017.” MMWR. Morbidity and Mortality Weekly Report 68 (18): 423–29.

Petersen, Emily E., Nicole L. Davis, David Goodman, Shanna Cox, Carla Syverson, Kristi Seed, Carrie Shapiro-Mendoza, William M. Callaghan, and Wanda Barfield. 2019. “Racial/Ethnic Disparities in Pregnancy-Related Deaths — United States, 2007–2016.” MMWR. Morbidity and Mortality Weekly Report 68 (35): 762–65.

“Report from MMRCs: A View into Their Critical Role.” 2017. Building U.S. Capacity to Review and Prevent Maternal Deaths.

Thoma, Marie E., and Eugene R. Declercq. 2022. “All-Cause Maternal Mortality in the US Before vs During the COVID-19 Pandemic.” JAMA Network Open 5 (6): e2219133.

Tikkanen, Roosa, Munira Z. Gunja, Molly FitzGerald, and Laurie Zephyrin. 2020. “Maternal Mortality and Maternity Care in the United States Compared to 10 Other Developed Countries.” The Commonwealth Fund.

Vedam, Saraswathi, Kathrin Stoll, Marian MacDorman, Eugene Declercq, Renee Cramer, Melissa Cheyney, Timothy Fisher, Emma Butt, Y. Tony Yang, and Holly Powell Kennedy. 2018. “Mapping Integration of Midwives across the United States: Impact on Access, Equity, and Outcomes.” Edited by Dongmei Li. PLOS ONE 13 (2): e0192523.

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