Maternal mortality statistics: why 87% of pregnancy-related deaths are preventable

In 2021, a 32-year-old woman in Mississippi died from a postpartum hemorrhage 11 hours after delivering a healthy baby. A maternal mortality review committee later determined that her death was preventable. So were most of the others.

Maternal mortality in the United States is not a fringe problem. It is a defining failure of the American healthcare system. The U.S. has the highest maternal mortality rate of any high-income country, and the gap has been widening for two decades. The numbers are not abstract: 908 women died from pregnancy-related causes in 2021 alone, according to the National Center for Health Statistics.

What makes this data particularly hard to sit with is that the CDC's Maternal Mortality Review Committees have concluded that the vast majority of these deaths did not have to happen.

How many women die from pregnancy in the U.S.

The National Center for Health Statistics reported 908 maternal deaths in the United States in 2021, translating to a maternal mortality rate of 32.9 per 100,000 live births. That rate had been climbing: in 2018, it was 17.4. In 2020, it was 23.8.

Some of the jump between 2020 and 2021 reflects a change in how deaths are counted. In 2018, the U.S. adopted a standardized pregnancy checkbox on death certificates nationwide, which improved identification of pregnancy-related deaths that had previously been missed. COVID-19 also contributed directly to maternal deaths during 2020-2021. But the underlying trend predates the pandemic and the measurement change.

Between 2000 and 2014, the U.S. maternal mortality rate roughly doubled while rates in most other wealthy nations declined. That divergence is not explained by demographics alone. It reflects policy choices, insurance gaps, fragmented care systems, and chronic underinvestment in postpartum support.

The most recent CDC data available for Maternal Mortality Review Committee analysis covers 2017 to 2019: 36 states, 1,018 pregnancy-related deaths. Those findings are the basis for much of what we know about why these women died and whether their deaths could have been prevented.

Most of these deaths are preventable

Of the 1,018 pregnancy-related deaths reviewed by CDC Maternal Mortality Review Committees for 2017-2019, 87% were determined to be preventable. Not "theoretically preventable under ideal conditions." Preventable given the healthcare resources that were available at the time and in the location where the death occurred.

That number should stop you. Nearly 9 out of 10 women who died from pregnancy-related causes did not have to die.

The review committees identified contributing factors for each death. The most common were:

• Patient/family factors (such as lack of knowledge about warning signs): 44%
• Provider factors (misdiagnosis, delayed treatment, lack of clinical skill): 65%
• Facility factors (inadequate staffing, policies, or equipment): 48%
• System factors (insurance gaps, transportation barriers, fragmented care): 37%

Provider-related factors appeared in nearly two-thirds of preventable deaths. This is not about blaming individual clinicians. It is about recognizing that the systems in which they work are failing at predictable, identifiable points. Women are showing up with symptoms. The symptoms are being missed, dismissed, or treated too late.

Mental health as a leading cause

One of the most significant findings from the 2017-2019 MMRC data is that mental health conditions are the leading underlying cause of pregnancy-related death. That category includes suicide and overdose, along with other deaths linked to depression, anxiety, substance use disorders, and psychosis during pregnancy or in the year afterward.

When you hear "maternal mortality," you might picture a hemorrhage in a delivery room. Hemorrhage does account for a significant share. But mental health conditions, broadly defined, now account for about 23% of pregnancy-related deaths, more than any single obstetric cause. Hemorrhage accounts for about 14%. Cardiovascular conditions account for about 13%.

Underlying cause	Share of pregnancy-related deaths
Mental health conditions	23%
Hemorrhage	14%
Cardiovascular conditions	13%

Source: CDC Maternal Mortality Review Committees, 2017-2019 (Trost et al., MMWR 2024)

Most of these mental health-related deaths occurred between 42 days and 1 year postpartum, a period when many women have already been discharged from obstetric care and may not have a clear medical home. That is the gap. The American healthcare system is structured around labor and delivery, then a single 6-week postpartum visit. What happens after that is largely left to chance.

If you are pregnant or postpartum and struggling with anxiety, depression, or intrusive thoughts, that is not weakness. It is a medical condition, and one clinicians still undertreat. Our article on women's mental health statistics covers the broader picture. The postpartum period carries its own elevated risk.

The racial disparity in maternal deaths

The racial gap in maternal mortality is one of the starkest health disparities in the United States.

In 2021, the maternal mortality rate for Black women was 69.9 per 100,000 live births. For white women, it was 26.6. For Hispanic women, it was 28.0. Black women are dying from pregnancy-related causes at 2.6 times the rate of white women. In some states and for some years, the ratio is closer to 3 to 4 times higher.

Group	Rate per 100,000 live births
Black, non-Hispanic	69.9
Hispanic	28.0
White, non-Hispanic	26.6

Source: Hoyert DL, Maternal Mortality Rates in the United States, 2021, NCHS Data Brief No. 462

This disparity is not new. A CDC analysis of data from 2007 to 2016 found that Black women were 3.3 times more likely to die from pregnancy-related causes than white women, and American Indian/Alaska Native women were 2.3 times more likely. The gap persists across education and income levels. A Black woman with a college degree has a higher maternal mortality risk than a white woman who did not finish high school.

That last statistic matters because it eliminates the most common deflection: that the disparity is "really about poverty." Poverty plays a role, but it does not explain the gap on its own. Research points to the cumulative physiological toll of racism (sometimes called weathering), bias in clinical decision-making, lower quality of care at hospitals where Black women disproportionately deliver, and insurance gaps tied to state-level decisions about Medicaid expansion.

Twelve states have not expanded Medicaid under the Affordable Care Act. These states have higher rates of uninsurance among women of reproductive age and higher maternal mortality rates. The overlap is not coincidental.

How the U.S. compares to other countries

Among wealthy nations, the United States is an outlier.

A 2022 Commonwealth Fund report comparing 14 high-income countries found that the U.S. had the highest maternal mortality rate by a wide margin. The U.S. rate in 2020 was 23.8 per 100,000 live births. The next closest was New Zealand at 13.6. France was at 8.7. Norway was at 2.4.

Country	Maternal mortality rate (per 100,000 live births)	Year
United States	23.8	2020
New Zealand	13.6	2020
France	8.7	2020
Canada	8.4	2020
United Kingdom	7.3	2020
Germany	4.2	2020
Norway	2.4	2020

Source: Commonwealth Fund, 2022; WHO maternal mortality estimates, 2020

The U.S. spends more per capita on healthcare than any of these countries. It spends more on maternity care specifically. And yet outcomes are worse. The Commonwealth Fund report attributed the gap to the U.S. system's fragmented care, lack of universal insurance, limited postpartum coverage, and higher rates of chronic conditions among pregnant women.

When maternal deaths happen

A common misconception is that maternal deaths primarily occur during childbirth. CDC timing data shows otherwise.

Among the 1,018 pregnancy-related deaths reviewed for 2017-2019:

• 22% occurred during pregnancy
• 25% occurred on the day of delivery or within 6 days afterward
• 53% occurred between 7 days and 1 year postpartum

Timing	Share of pregnancy-related deaths
During pregnancy	22%
Day of delivery or within 6 days	25%
7 days to 1 year postpartum	53%

Source: CDC Maternal Mortality Review Committees, 2017-2019

More than half of pregnancy-related deaths happen after the first week postpartum. That has direct implications for how maternity care is structured. The traditional model puts intensive monitoring during pregnancy and labor, then a single follow-up visit at 6 weeks. It leaves the highest-risk period largely uncovered.

Deaths in the late postpartum period (42 days to 1 year after delivery) are dominated by mental health conditions and cardiomyopathy, with substance use disorders also common. These problems develop or worsen gradually. They need ongoing monitoring that the current system does not reliably provide.

What is driving these numbers

Several factors converge to make the U.S. maternal mortality rate as high as it is.

Rising rates of chronic conditions. More women are entering pregnancy with pre-existing hypertension, diabetes, obesity, or heart disease. The CDC found that cardiovascular conditions are the leading medical cause of pregnancy-related death (distinct from mental health, which is the leading underlying cause). Chronic hypertension among pregnant women has been increasing, partly driven by the trend toward later childbearing.

Insurance instability. About 1 in 4 women experience a gap in insurance coverage during the year before, during, or after pregnancy. Many women with Medicaid-covered births lose coverage 60 days postpartum, precisely when the risk of late maternal death is highest. The American Rescue Plan Act encouraged states to extend Medicaid postpartum coverage to 12 months, and as of 2024, most states have adopted this extension, though not all.

Maternity care deserts. The March of Dimes defines a maternity care desert as a county with no hospital offering obstetric care and no OB/GYN or certified nurse-midwife. As of 2022, more than 1,100 U.S. counties (over a third of all counties) qualified as maternity care deserts or had limited access. Rural women travel farther for care and deliver at less-equipped facilities. They have fewer options for emergency obstetric services.

Fragmented care coordination. Women see multiple providers across pregnancy and the postpartum period. Medical records do not always follow them. Warning signs documented in one setting may not be visible in another. CDC review committees cited communication failures between providers as a contributing factor in a large share of preventable deaths.

UK data shows a similar trend

The problem is not confined to the United States. The most recent MBRRACE-UK report, covering maternal deaths in the United Kingdom, found that maternal mortality rates have increased approximately 20% compared to the 2009-2011 triennium. The UK's rate remains far lower than the U.S. rate in absolute terms. The trend is still in the wrong direction.

MBRRACE-UK data has consistently identified cardiac disease and thromboembolism among the leading causes of maternal death in the UK, with mental health conditions also prominent. The 2026 report emphasized that women with pre-existing medical conditions need earlier, more coordinated multidisciplinary care. That conclusion closely mirrors what U.S. review committees have found.

The UK's data infrastructure is worth noting. MBRRACE-UK reviews every maternal death in the country, identifies contributing factors, and publishes detailed recommendations. The U.S. has nothing comparable at the national level. CDC Maternal Mortality Review Committees operate state by state, and participation is voluntary. As of 2024, 42 states have active review committees, but data sharing and methodology vary.

What needs to change

The CDC review committees do not just count deaths. They recommend specific changes. The most frequently cited recommendations from the 2017-2019 data include:

• Extending health insurance coverage through at least 12 months postpartum
• Screening for mental health conditions at every prenatal and postpartum visit
• Improving patient education about warning signs (severe headaches, excessive bleeding, chest pain, difficulty breathing)
• Training hospital staff on obstetric emergency protocols, particularly for hemorrhage and hypertensive emergencies
• Addressing implicit bias through standardized clinical protocols that do not rely on subjective assessment of patient pain or urgency

Some of these changes are already underway. The Momnibus Act, introduced in Congress, proposes expanded Medicaid coverage and investments in the maternal health workforce, plus funding for community-based organizations. State-level work in California and Illinois (and similar efforts in New Jersey) has shown that maternal mortality rates can fall when hospitals adopt hemorrhage bundles, hypertension protocols, and perinatal quality collaboratives.

California is the best example. The state's maternal mortality rate dropped by 55% between 2006 and 2013 after implementing standardized protocols for hemorrhage and preeclampsia. The California Maternal Quality Care Collaborative became a model that other states are working to replicate.

If you are pregnant or planning to become pregnant, tracking your cycle and due dates can help you stay engaged with your care timeline. Our period calculator, ovulation calculator, and IVF date calculator are tools designed for that purpose.

Frequently asked questions about maternal mortality

How many women die from pregnancy-related causes each year in the U.S.?

In 2021, 908 women died from pregnancy-related causes in the United States, according to the National Center for Health Statistics. The maternal mortality rate was 32.9 per 100,000 live births. This rate has been rising over the past two decades, though changes in how deaths are recorded and the impact of COVID-19 account for some of the recent increase.

What percentage of maternal deaths are preventable?

The CDC's Maternal Mortality Review Committees determined that 87% of pregnancy-related deaths between 2017 and 2019 were preventable. Contributing factors included provider-level failures (65%), patient/family knowledge gaps (44%), facility limitations (48%), and system-level barriers (37%). Most deaths involved multiple contributing factors across these categories.

Why is the maternal mortality rate higher for Black women?

Black women die from pregnancy-related causes at 2.6 to 3 times the rate of white women. In 2021, the rate was 69.9 per 100,000 live births for Black women versus 26.6 for white women. The disparity persists across income and education levels and is driven by cumulative effects of racism, bias in clinical settings, lower quality of care at delivery hospitals, and higher rates of uninsurance in states that have not expanded Medicaid.

What is the leading cause of pregnancy-related death?

Mental health conditions, including suicide and substance use-related overdose, are the leading underlying cause of pregnancy-related death in the U.S. according to 2017-2019 CDC MMRC data. They account for about 23% of deaths. Hemorrhage (14%) and cardiovascular conditions (13%) are the next most common medical causes. Most mental health-related deaths occur between 42 days and 1 year after delivery.

How does the U.S. maternal mortality rate compare to other countries?

The United States has the highest maternal mortality rate among high-income nations. In 2020, the U.S. rate was 23.8 per 100,000 live births, compared to 7.3 in the UK, 8.7 in France, and 2.4 in Norway, per Commonwealth Fund and WHO data. The U.S. spends more on healthcare per capita than any of these countries, yet outcomes are significantly worse.

When do most maternal deaths occur?

More than half (53%) of pregnancy-related deaths occur between 7 days and 1 year after delivery, per CDC data from 2017-2019. Another 25% occur during delivery or within the first 6 days, and 22% occur during pregnancy. Late postpartum deaths are driven mainly by mental health conditions and cardiomyopathy; substance use disorders also figure heavily. All of these need ongoing monitoring beyond the standard 6-week postpartum visit.