Maternal death in the United States is rare but serious: each year, a small number of women die during pregnancy or within one year postpartum, largely from preventable conditions. The U.S. maternal mortality rate rose in the late 2010s and remained elevated compared with many high-income countries before showing signs of stabilization. The leading causes include hemorrhage, cardiovascular and cardiomyopathy conditions, infection, thrombotic embolism, and hypertensive disorders such as preeclampsia. Understanding how many women die during childbirth in the US, why these deaths occur, and which factors increase risk is essential for clinicians, policymakers, and people who are pregnant or postpartum and their families.
Measuring Maternal Mortality in the United States
Maternal mortality is defined as the death of a woman while pregnant or within one year of the end of a pregnancy from causes related to or aggravated by the pregnancy or its management. In the US, maternal deaths are tracked through vital records, pregnancy mortality surveillance systems, and data from state and national health agencies. Key sources include the National Vital Statistics System and CDC Pregnancy Mortality Surveillance System. Analysts typically examine the maternal mortality ratio (number of maternal deaths per 100,000 live births) to monitor trends and compare outcomes across populations and over time.
Pregnancy Mortality Surveillance System (PMSS)
The PMSS is a national population-based surveillance system that monitors pregnancy-related deaths across jurisdictions. It links death certificates, birth certificates, and pregnancy records to identify pregnancy-associated deaths and determine whether they were pregnancy-related. Reviews by multidisciplinary committees assess preventability and contributing factors. These data are critical for informing clinical guidelines, public health interventions, and policy aimed at reducing maternal mortality in the United States.
How Many Women Die During Childbirth in the US
Because U.S. maternal deaths are relatively uncommon but unevenly distributed, exact counts fluctuate by year. In recent years, the national maternal mortality ratio increased from the late 1990s through the 2010s, peaking in 2021, then showing some variability. Disparities by race and ethnicity, age, and underlying conditions are pronounced, with certain groups facing substantially higher risk. Reviews of deaths consistently find that a significant proportion are preventable through timely access to high-quality care, recognition of warning signs, and evidence-based interventions.
Comparison Snapshot: U.S. Maternal Mortality Trends
| Metric | Verified Detail | Source Type |
|---|---|---|
| Maternal Mortality Ratio (2021) | Approximately 32.9 deaths per 100,000 live births | CDC PMSS provisional data |
| Leading Causes | Hemorrhage, cardiomyopathy, infection, thrombotic embolism, hypertensive disorders | CDC PMSS cause-of-de classifications |
| Timing of Deaths | Most occur during pregnancy or within the first 42 days postpartum, with late postpartum deaths up to one year also significant | PMSS period definitions |
| Disparities | Non-Hispanic Black women are approximately 2–3 times more likely to die relative to non-Hispanic White women | CDC and national surveillance reports |
Leading Causes of Maternal Death
Hemorrhage is the most common cause of maternal mortality, emphasizing the importance of structured obstetric hemorrhage protocols and well-prepared delivery teams. Cardiovascular disease and cardiomyopathy are increasingly prevalent causes, reflecting the burden of preexisting and pregnancy-associated heart conditions. Infection-related deaths, while less common in settings with effective prophylaxis and timely antibiotics, remain a priority for prevention. Thrombotic embolism, including pulmonary embolism, contributes significantly to deaths, particularly in the postpartum period. Hypertensive disorders of pregnancy such as preeclampsia and eclampsia can lead to stroke and organ failure without careful monitoring and treatment.
Critical Preventable Factors
- Delays in recognizing and treating hemorrhage, hypotension, and shock
- Inadequate management of hypertensive emergencies and eclampsia
- Missed or delayed diagnosis of infection and postpartum sepsis
- Insufficient thrombosis prophylaxis and recognition of warning signs
- Structural barriers and implicit bias contributing to unequal care
Risk Factors and Disparities
Risk factors for maternal mortality include advanced maternal age, chronic conditions such as hypertension and diabetes, obesity, substance use disorders, and limited prenatal care. Structural inequities—systemic racism, economic instability, and fragmented health care access—drive disproportionate harm to Black and Indigenous women, who experience higher rates of severe maternal morbidity and mortality compared with white women. Addressing disparities requires coordinated efforts across health care systems, communities, and social services to improve access before, during, and after pregnancy.
Prevention and Clinical Best Practices
Preventing maternal deaths depends on early and ongoing prenatal care, recognition of warning signs, and rapid escalation of care when complications arise. Key strategies include hemorrhage preparedness drills, use of validated early warning tools, timely obstetric consultations, and consistent thromboprophylaxis after cesarean delivery and other risk situations. Care models that integrate behavioral health support, chronic disease management, and contraception counseling can reduce preventable risks. Facility-level protocols, interprofessional communication, and continuous quality improvement initiatives are central to safer maternity care in the United States.
Recovery, Mental Health, and Long-Term Outcomes
Survivors of severe maternal morbidity may face physical, emotional, and practical challenges, including mental health conditions such as postpartum depression, anxiety, and symptoms of PTSD related to the birth experience. Follow-up care that includes mental health screening, coordinated referrals, and social support can improve recovery trajectories. Planning for future pregnancies with shared decision-making and optimized medical management helps reduce cumulative risk. Supporting survivors with respectful communication, clear explanations, and coordinated care is essential for long-term well-being.
The Role of Data, Policy, and Public Health
Ongoing surveillance, standardized reporting, and detailed reviews of each maternal death enable public health leaders and clinicians to identify gaps and implement targeted interventions. Policy efforts that expand access to affordable care, improve workforce training, and fund community-based support programs contribute to sustained reductions in maternal mortality. Continued investment in data infrastructure, research, and equity-focused initiatives is necessary to make meaningful progress and ensure that every pregnancy in the United States is as safe as possible.
FAQ
Reader questions
What counts as a maternal death in the United States?
A maternal death in the U.S. is defined as a death during pregnancy or within one year postpartum from a cause related to or aggravated by the pregnancy or its management. Reviews by pregnancy mortality surveillance systems classify deaths as pregnancy-related or not and assess preventability based on clinical and contextual factors.
What are the most common causes of maternal death in the US?
Hemorrhage, cardiomyopathy, infection, thrombotic embolism, and hypertensive disorders such as preeclampsia and eclampsia are the leading causes of pregnancy-related mortality in the United States.
Why are disparities in maternal mortality by race and ethnicity significant?
Non-Hispanic Black and some Indigenous women in the U.S. experience a substantially higher risk of maternal death compared with white women. These disparities are driven by structural inequities, chronic stress, unequal access to care, and bias within health care systems, and they persist even when socioeconomic factors are accounted for.
Can most maternal deaths in the United States be prevented?
Yes, a significant proportion of U.S. maternal deaths are considered preventable through timely access to high-quality care, standardized protocols, early recognition of complications, and coordinated follow-up before, during, and after pregnancy.
How can people who are pregnant reduce their risk of maternal mortality?
People who are pregnant can reduce risk by attending recommended prenatal visits, managing chronic conditions, seeking early care for warning signs (such as heavy bleeding, severe headaches, chest pain, or shortness of breath), and discussing mental health and social support needs with their care team.