U.S. Sees Continued Rise in Maternal Mortality

May 10, 2016|1:10 p.m.| Eighmey Zeeck

The United States has one of the highest rates of maternal mortality of any industrialized country, with current rates at 14 maternal deaths per every 100,000 live births. CDC and the World Health Organization define maternal mortality as death related to pregnancy or management of pregnancy, and it is an indicator of a country’s healthcare system. Maternal mortality rates are impacted by maternal morbidity, which includes non-life threatening to potentially fatal incidents for a woman and fetus both during and after pregnancy. The more life threatening form of maternal morbidity is called severe maternal morbidity and affects approximately 50,000 women in the United States annually, and that number continues to grow.

Healthy People 2020 has set a goal to reduce the rates of maternal mortality within the United States by ten percent, to 11.4 deaths per 100,000 live births. Despite this, maternal mortality rates in the United States have increased since this goal was set, with rates reaching as high as 17.8 deaths per 100,000 live births in both 2009 and 2011.

Understanding the troubling trend

Why is there an increase instead of a decrease? Maternal mortality and morbidity rate increases may be attributed to access to care. Minority women and women living at or below the poverty line have the highest rates of maternal mortality and morbidity in the U.S. These women have maternal mortality rates nearly three times higher than white women. It should be noted that the Affordable Care Act has enabled more people to access health insurance, but barriers to medical care still exist including health system navigation, transportation, and paid leave. Lack of appropriate medical care has a correlation with chronic disease, a risk factor for increased maternal mortality. Chronic disease is responsible for seven out of ten deaths in the U.S. each year, according to CDC, with roughly half of all adults having at least one chronic disease. Lack of proper management of such diseases prior to pregnancy can lead to complications during pregnancy, which may lead to death. 

Other risk factors for maternal mortality include, but are not limited to:

  • Age – risk increases after age 35
  • Pre-pregnancy obesity
  • Gestational weight gain
  • Gestational diabetes
  • Substance use - illegal substances, alcohol and use of tobacco products
  • Safe and affordable housing issues
  • Mental health  
  • Violence and/or neglect
  • An increased rate of elected caesarean sections

Helping states address maternal mortality and morbidity

ASTHO is dedicated to ensuring that all women experience safe births and has created a position statement addressing maternal mortality and morbidity. The statement provides recommendations on how to improve pregnancy and birth outcomes at the state, local, and federal level. Other recommendations include collaborating with organizations in order to incorporate social, economic, and health changes to improve maternal access to care, which then allow for increased access to medical care during the life cycle of both the mother and child. Through the Alliance for Innovation on Maternal Health program ASTHO is working with the American Congress of Obstetricians and Gynecologists to help states implement new measures to address maternal mortality and morbidity. The program promotes collaboration between states and birth facilities to implement consistent maternal care to reduce primary cesarean births, reduce racial disparities, and promote postpartum and interconception care.

Eighmey Zeeck

Eighmey Zeeck, MPH is an intern for maternal and child health at ASTHO. She graduated August 2015 with a Master of Public Health degree from George Washington University with a focus on global health. Zeeck supports ASTHO projects related to access to care for women and children.