The nation’s maternal mortality rate increased by nearly 40% between 2020 and 2021. The rate of US women who died during or soon after their pregnancies in the US is higher than at any other time since 2000, according to new data from the Centers for Disease Control and Prevention (CDC).
The rate was higher for certain groups in the population, such as pregnant Black women. The COVID-19 pandemic and the rising age of pregnant women also contributed to the worsening rate.
It's not a new problem in the US. Although the maternal mortality rate dropped in some years over the last two decades, the overall trend has been upwards.
The World Health Organization defines maternal mortality as the death of a woman while pregnant or within 42 days of the end of pregnancy, regardless of how long the pregnancy lasted or any cause related to the pregnancy.[1]
How have maternal mortality rates changed over time?
The overall maternal death rate in the US rose from 23.9 deaths per 100,000 live births in 2020 to 32.9 per 100,000 in 2021. The rate more than doubled since 2000, from 9.8 deaths for every 100,000 live births, according to the CDC.
In 2021, 1,205 women died either during or within 42 days of the end of their pregnancy, compared with 396 in 2000.
The maternal mortality rate is a key indicator of women's health, according to the Department of Health and Human Services.
How do maternal mortality rates vary by race and ethnicity?
Black women consistently have the nation’s highest maternal mortality rate. In 2014, the Black maternal mortality rate was 52.4 deaths per 100,000 births compared to the national rate of 21.5 per 100,000. That’s more than two times higher, and worse than any other racial or ethnic group. Things haven’t gotten better:
The Black maternal mortality rate rose from 55.3 deaths per 100,000 live births in 2020 to 69.9 from 2020 to 2021.
A 2019 CDC report offered some potential reasons for the higher Black mortality rate, including hypertension and other chronic diseases associated with high maternal mortality rates are more common among Black women. The CDC report also cites a national study that found similar rates of common pregnancy complications but higher case fatalities for Black women. Quality of care is often worse for the group and implicit racial bias can impact patient-provider interactions.
Hispanic women had the largest maternal mortality rate increase from 2020 to 2021, up 54%. This latest increase was the biggest annual rise between 2014 and 2021. Historically, Hispanic women have lower maternal mortality rates compared to Black women.
What does age have to do with maternal mortality?
The trend of older women giving birth affects the maternal mortality rate, as mortality risks rise with the age of the mother.
The median age of women giving birth for the first time in the US increased from 24.9 to 27.1 between 2000 and 2020. Women 30–44 accounted for 49% of births in 2020, up from 39% in 2010. The share of births from women 40 and up increased from about 2% in 2000 to about 4% in 2020.
The maternal mortality rate for women 40 and older was 138.5 deaths for every 100,000 live births in 2021, a 28% increase from 2020. Their rate was 6.8 times higher than for women under 25, which was 20.4 per 100,000 live births. However, rates rose or this group from 2020 to 2021 as well. The rate of maternal deaths for women younger than 25 increased by 48% and by 37% for women 25–29.
Comparing maternal mortality rates: how does the US rank against other countries?
While the maternal mortality rate increased in the US from 9.8 deaths per 100,000 births in 2000 to 32.9 deaths per 100,000 births in 2021, the rate decreased in many other countries. From 2000 to 2020, the World Health Organization estimated that maternal mortality rates decreased globally by 34%. The US ranks poorly compared to other developed nations, 120th among the 189 countries and territories.
The United States had twice the maternal mortality rate of the United Kingdom. It also had a higher rate than occupied Palestinian territory,[2] at 20 deaths per 100,000 births.
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[1] The maternal mortality rate doesn’t include accidental or incidental deaths.
[2] Including East Jerusalem
