How Many Women Die Before, During and After Childbirth?

For the first time in more than a decade, the U.S. government has released new data on the U.S. maternal mortality rate — and unfortunately it presents a grim picture.

According to a report released in January from the Centers for Disease Control and Prevention’s National Vital Statistics System, the 2018 maternal mortality rate was 17.4 deaths per 100,000 live births, meaning that 658 women died from pregnancy-related causes. The figure includes deaths during pregnancy, at birth or within 42 days of birth.

Other significant findings relating to maternal death include:

• The maternal death rate for non-Hispanic black women was more than double that for non-Hispanic white women: 37.1 deaths per 100,000 live births compared with 14.7.
• The maternal death rate for non-Hispanic black women was more than three times the rate of Hispanic women, which was 11.8 deaths per 100,000 live births.
• The maternal death rate increased with age: The rate for women ages 40 through 44 was 81.9 deaths per 100,00 live births, compared with a maternal death rate of 16.6 for women ages 25 through 39 and a rate of 10.6 for women under age 25.

Note that although the 2018 data excludes deaths occurring 42 days after birth, the CDC reports that about one-third of pregnancy-related deaths happen one week to one year postpartum.

Why Did It Take a Decade for the U.S. to Publish Its Maternal Mortality Rate?

Data collection on maternal deaths hit a roadblock in 2003 when the government added a pregnancy status “checkbox” to its revised U.S. Standard Certificate of Death. Physicians were instructed to check a box for a known pregnancy in defined time frames prior to death. Since states individually control their vital registration systems, this recommendation was implemented gradually nationwide as funding, technology and state laws allowed. This implementation process ended in 2017, when the last state added a checkbox to its death certificate.

During implementation, the National Center for Health Statistics (NCHS) paused its reporting of maternal mortality. The last time NCHS published a national maternal mortality rate was in 2007. That rate was 12.7 maternal deaths per 100,000 live births. The CDC attributes 2018’s higher rate to changes in the way that the data was collected and reported.

How Can the U.S. Reduce Maternal Mortality?

A study published recently in the journal of Women’s Health Issues provides hope for decreasing U.S. maternal mortality through Medicaid expansion.

The study found that from 2006 to 2017, states that expanded Medicaid under the Affordable Care Act were significantly associated with lower maternal mortality by about seven maternal deaths per 100,000 live births relative to states that did not expand.

In November, the U.S. House of Representatives Committee on Energy and Commerce advanced the Helping Medicaid Offer Maternity Services (MOMS) Act of 2019, which would offer incentives to states to continue Medicaid coverage for women for one year after delivery.