Background
Maternal mortality in the United States remains a deeply concerning public health issue, especially when compared to other high-income nations. A 2024 report from the Commonwealth Fund shows that the U.S. has the highest maternal mortality rate among developed countries, significantly outpacing peers like Germany, France, and Japan (Commonwealth Fund, 2024).
Within the U.S., maternal mortality rates vary widely by geography. Using the CDC’s WONDER database, we found that Mississippi (53.9), Arkansas (55.1), and North Carolina (52.5) reported the highest rates per 100,000 live births in 2023.
Racial disparities are also stark. Non-Hispanic Black women experience maternal mortality at a rate 3.55 times higher than non-Hispanic White women (MacDorman, M. F., Thoma, M., Declcerq, E., & Howell, E. A. (2021). Racial and ethnic disparities in maternal mortality in the United States using enhanced vital records, 2016‒2017. American journal of public health, 111(9), 1673-1681). These disparities reflect broader systemic inequities in healthcare access, quality, and outcomes.
To address these challenges, the U.S. government has invested hundreds of millions of dollars in maternal health initiatives. A significant portion of this funding supports Maternal Mortality Review Committees (MMRCs), which usually convene quarterly at state or local levels to examine deaths occurring during pregnancy or within one year postpartum. These committees analyze individual cases, identify contributing factors, and issue recommendations aimed at prevention.
From 2017 to 2019, MMRCs identified a range of causes of maternal death, including mental health conditions, hemorrhage, cardiac and coronary conditions, infection, thrombotic embolism, cardiomyopathy, hypertensive disorders of pregnancy, amniotic fluid embolism, injury, cerebrovascular accidents, cancer, metabolic/endocrine disorders, and pulmonary conditions. Importantly, nearly 100% of mental health-related maternal deaths were found to be preventable.
Where Do We Go From Here?
Improving maternal health outcomes in the U.S. requires a coordinated, evidence-based approach that prioritizes equity, accountability, and compassion. In particular, we could focus on:
- Targeted Interventions: Maternal mortality disproportionately affects specific demographic groups. Policies must be tailored to address disparities based on race, income, and education.
- Sustained and Accountable Funding: Continued investment in maternal health is essential. However, funding must be accompanied by rigorous evaluation and transparent reporting. Privacy protections are also critical. Georgia’s temporary disbanding of its MMRC due to privacy concerns illustrates the need for thoughtful data governance (ProPublica, 2023).
- Focus on Preventable Deaths: Many maternal deaths are preventable, and efforts should prioritize these cases. Mental health-related deaths, in particular, are almost entirely preventable. Expanding access to perinatal mental health services, integrating behavioral health into prenatal care, and reducing stigma around mental health can save lives.
