The rate of women who died during pregnancy in the US is higher than at any other time since 2000, according to recently released data from the CDC.
This rate, also known as the maternal mortality rate, increased by nearly 20% between 2019 and 2020. The rate was higher for subgroups of the population such as pregnant Black women. The COVID-19 pandemic and the rising age of pregnant women also contributed to the worsening maternal mortality rate.
It's not a new problem in the US. The rate of women dying during pregnancy has steadily increased in the US over the last two decades.
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. Accidental or incidental causes of death aren't part of the maternal mortality rate.
The maternal mortality rate is a key indicator of the state of women's health, according to the Department of Health and Human Services.
While US maternal mortality rates increased from 9.8 deaths per 100,000 births in 2000 to 23.8 deaths per 100,000 births in 2020, the rate of women dying in childbirth is decreasing in many other countries. From 1990 to 2015, the maternal mortality rate worldwide decreased by 44%. The US ranks poorly compared to other developed nations, ranking 46th among 181 countries.
How the maternal mortality rate has changed over the last 20 years
About 14 babies per 1,000 people were born on average between 2000-2010. That number declined in recent years. Over the same period, the maternal death rate got worse.
The overall maternal death rate in the US increased from 20.1 deaths per 100,000 live births in 2019 to 23.8 deaths per 100,000 in 2020. Since 2000, the rate more than doubled, from 9.8 deaths for every 100,000 live births, according to the CDC.
In total, 861 women in 2020 died either during or within 42 days of the end of their pregnancy, compared with 396 in 2000.
The pandemic worsened the existing gap in maternal mortality rates for Black women
Black women consistently have the highest maternal mortality rate in the US. In 2000, the Black maternal mortality rate was 22 deaths per 100,000 births compared to the national rate of 9.8 deaths per 100,000 births. That’s more than two times higher, and worse than any other racial or ethnic group.
The disparity got worse in 2020. The rate rose from 44 deaths per 100,000 live births to 55.3 from 2019 to 2020, the second biggest increase of any racial or ethnic group, behind Hispanic women.
A 2019 CDC report offered some potential reasons for the higher mortality rate for Black women. It states that chronic diseases associated with high maternal mortality rates such as hypertension are more common among Black women. Quality of care is often worse for the group. The CDC report also cites a national study that found similar rates of common pregnancy complications but higher case fatalities for Black women. And implicit racial bias can impact every patient-provider interaction.
Hispanic women experienced the largest increase in maternal mortality rates from 2019 to 2020, rising by 44%. The latest increase was the biggest annual rise in maternal mortality for Hispanic women since 2000. Historically, Hispanic women have lower maternal mortality rates compared to other race or ethnic groups.
Women 40 and older had the highest maternal mortality rates
Women are giving birth at older ages than before, affecting maternal mortality rates overall.
The median age of women giving birth in the US increased from 24.9 to 27.1 between 2000 and 2020. Women aged 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 rises as the age of the mother increases.
The maternal mortality rate for women 40 and older was 107.9 deaths for every 100,000 live births in 2020, a 43% increase from 2019. The maternal mortality rate for pregnant women 40 and older was 7.8 times higher than for women under 25, 13.8 per 100,000 live births. The rate of maternal mortality for women younger than 25 increased slightly between 2019 and 2020 by 9.5% and 14% for women aged 25-29.
The US maternal mortality rate is one of the highest among developed countries
The World Health Organization reported that maternal mortality rates had fallen globally by 44% from 1990 to 2015. At the same time, the maternal mortality rate increased in the United States. In 2015 the US ranked 46th among the 181 countries with a maternal mortality rate of 20.9 deaths per 100,000 births—one of the highest rates among developed countries.
The United States had a higher maternal mortality rate than Canada, Finland, and the United Kingdom in 2017—the most recent data available for these countries.
Read more about health in the United States at the State of the Union in Numbers.
