Maternal mortality is too high in the US regardless of how deaths are counted

April 22, 2024

The Centers for Disease Control and Prevention (CDC) has been publishing data on maternal mortality for years, and last year published shocking data that maternal mortality had increased from 17 deaths per 100,000 live births in 2018 to 33 deaths per 100,000 live births in 2021. The most recent statistics show the maternal mortality rate went down to 22 deaths per 100,000 live births in 2022.

This used the CDC’s standard definition for maternal mortality, which is a death of a woman between ages 10-44 within a year of delivery where “pregnancy related” is checked on the death certificate. This means that deaths from homicide, accidents, and suicide are included if childbirth was an underlying cause.

Last month, researchers published a paper in the American Journal of Obstetrics and Gynecology  (AJOG)  that used a different methodology to restrict maternal mortality to conditions likely to be amenable to obstetrical interventions, and required that pregnancy was explicitly mentioned on the death certificate. This methodology ignored the checkbox.

This graphic from Emily Oster, an economics professor at Brown University and the author of the excellent Parent Data newsletter, demonstrates the difference in reported mortality rates between the CDC methodology and the methodology of the AJOG.

Source, Oster, E Parent Data, April 15, 2024 LINK

The AJOG researchers’ methodology showed lower rates of maternal mortality, but their research continued to show that Black women are far more likely to die as a result of childbirth than other groups.

Black maternal deaths are substantially higher in alternative calculations, too

Source: Joseph, et al AJOG March 24, 2024 LINK

US maternal mortality is higher than other developed countries however it is counted. Here is data from the Bill and Melinda Gates Foundation (2020 data, except the top two lines that come from references above). Every maternal death is an unimaginable tragedy, and we can do better.

Source: Bill and Melinda Gates Foundation 2022 LINK

Implications for employers:

-        US maternal mortality remains stubbornly high, although it is surprisingly hard to count.

-        Black women are at special risk for maternal mortality -and doulas can make a difference.

-        Last week wasBlack Maternal Health week; every week is a good opportunity for us to consider how to make childbirth safer.

-        Here is  link to an article on what employers can do from Harvard Business Review (2023)

Thanks for reading.  You can find previous posts in the Employer Coverage archive

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Tomorrow: Factors associated with women not getting mammography