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Axios
Axios
Health

Study: Maternal deaths widespread beyond the South

Data:Institute for Health Metrics and Evaluation; Map: Tory Lysik/Axios Visuals

Maternal mortality rates more than doubled in the U.S. between 1999 and 2019 with states in the Midwest and Great Plains accounting for significant increases along with the South, according to a JAMA study that provides the first state-level breakdowns by ethnic group.

Driving the news: American Indians and Alaska Natives had the biggest increases, particularly in states in the middle of the country where such inequities "had not been previously highlighted," researchers wrote.


  • "Often, states in the South are called out as having the worst maternal mortality rates in the nation, whereas California and Massachusetts have the best. But that doesn't tell the whole story," said Allison Bryant, co-first study author and senior medical director for health equity at Mass General Brigham.
  • Overall, there were an estimated 1,210 maternal deaths in 2019, compared to 505 in 1999.
  • Maternal mortality is defined as a death that takes place during birth or up to a year later. The study looked at pregnant individuals aged 10 to 54.
  • Common causes of maternal death include mental health conditions (including death by suicide and overdose related to substance use disorder), hemorrhages, blood clots, high blood pressure and cardiac and coronary conditions.

By the numbers: The number of deaths per 100,000 live births rose from 12.7 to 32.2 in total from 1999 to 2019.

  • Broken down by group, deaths rose from 14.0 to 49.2 among American Indians and Alaska Natives; 26.7 to 55.4 among Black individuals, 9.6 to 20.9 among Asians, Native Hawaiians and other Pacific Islanders (AAPI); 9.6 to 19.1 among Hispanics; and 9.4 to 26.3 among white people, researchers found.

Zoom in: For American Indians and Alaska Natives, the states with the largest percentage increases were Florida, Kansas, Illinois, Rhode Island and Wisconsin, all of which were greater than 162%.

  • For the AAPI population, largest hikes were in Kansas, Illinois, Missouri, Michigan and Georgia, with all being over 83%.
  • Among Black people, they were in Louisiana, New Jersey, Georgia, Arkansas and Texas, which were all higher than 93%.
  • Hispanics saw largest increases in Indiana, Minnesota, Georgia, Tennessee and Illinois, all greater than 105%.
  • For white people, the most pronounced increases were observed in Indiana, Georgia, Tennessee, Louisiana and Missouri, all higher than 135%.

Editor's note: This story was updated with additional details.

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