Massive spike in pregnancy-related death in the US — here’s which states fare the worst

The United States continues to have the highest maternal mortality rate among wealthy nations — and new research suggests the crisis is deepening. 

A study published this week in JAMA Network Open found that the rate of these “largely preventable” deaths rose by nearly 28% between 2018 and 2022.

“The concerning rates in the US should be an urgent public health priority,” wrote the study authors, who also identified a disturbing gap between states when it comes to maternal deaths.

An alarming rise in maternal deaths

The study, using CDC data, focused on health issues during pregnancy and up to one year after delivery.

Out of more than 18 million live births that took place over the four year study period, researchers identified 6,238 pregnancy-related deaths among women ages 15 to 54.

Surprisingly, nearly a third of those deaths happened more than six weeks after childbirth. 

“Late maternal death occurs in what could be a health care delivery gap between obstetric care and transition to primary care,” the study authors noted. 

Crisis in the South 

If you’re in the Southeast, the news is especially bleak. 

These states had the highest rate of pregnancy-related deaths nationwide from 2018 to 2022, with Alabama topping the list at 59.7 deaths per 100,000 live births. Mississippi took second place. 

On the flip side, California had the lowest rate in the US. at 18.5 deaths per 100,000, followed by Minnesota. 

Notably, researchers said that if every state matched California’s number, more than 2,679 deaths could have been avoided over the four year stretch.

Young moms hardest hit

The study found that the rate of pregnancy-related deaths rose from 25.3 per 100,000 live births in 2018 to a peak of 44.1 in 2021, coinciding with the height of the coronavirus pandemic. The rate then fell slightly to 32.6 in 2022.

While the increase in deaths occurred across all age groups, women aged 25 to 39 experienced the most significant rise.

Cardiovascular disease — the number one cause of pregnancy-related deaths overall — played a major role in the spike, Dr. Rose L. Molina, one of the study’s authors, told The New York Times.

She explained that pregnancy puts extra stress on the heart and can worsen hidden or existing conditions like high blood pressure. At the same time, cardiovascular disease itself is becoming more common in younger adults.

“We seem as a society to be getting sicker earlier, which is why we’re seeing this in that particular age group,” said Molina, an associate professor of obstetrics, gynecology and reproductive biology at Harvard Medical School. 

Other leading culprits that fueled the rising death toll include cancer, mental health issues, substance abuse and alcohol. The study did not include accidents, homicides or other deaths not medically linked to pregnancy.

The racial and ethnic divide

In addition to the state-by-state disparities, researchers also identified widening gaps in pregnancy-related deaths among different races and ethnicities.

Native American and Alaskan Native women faced the highest rates, followed by Black women.

The study authors said this suggests that “these groups may face disparities in access to postnatal care, as well as other socioeconomic and systemic challenges impacting maternal health outcomes.”

On the other end of the spectrum, pregnancy-related deaths were lowest among White, Hispanic and Asian women.