Here’s What’s Wrong with the Updated US Maternal Mortality Statistics

A new official estimate of how many new and expectant people die from causes related to pregnancy and childbirth in the US has finally been released by the Centers for Disease Control (CDC), and as you probably could have guessed: It’s still terrible. 

Compared to 10 similarly wealthy countries, the US ranks 10th. The report from the CDC’s National Vital Statistics System shows that there were 17.4 deaths per 100,000 live births in 2018 in this country. That means we lost around 658 birthing people in 2018. 

The new maternal mortality calculation replaces 2007’s number, which was 12.7 deaths per 100,000 live births.  

What Counts as Maternal Mortality?

To qualify as maternal mortality, the CDC looked at deaths that occurred during pregnancy, birth or up to 42 days after birth. What’s not included in that rate, though, is deaths that occurred due to suicide or drug overdoses. The rate also didn’t include deaths that occurred after 42 days after giving birth. Read that again. Both omissions are significant because postpartum mental illness and some heart conditions can impact mortality rates and can present long after 42 days after giving birth. Because of this, we don’t have a complete picture of what maternal mortality in the US really looks like. In fact, previous CDC data shows that almost 24% of deaths happen within 43 to 365 days postpartum. 

In order to compare the maternal mortality rate in the US to the rest of the world, the CDC has to use the World Health Organization’s definition of maternal mortality, which goes until 42 days after birth.

Who’s Dying

Black birthing people are still dying at a rate of about two and half times higher than that of their white counterparts — 37.1 deaths per 100,000 live births compared to 14.7. Black birthing people are also three times as likely to die as their Hispanic counterparts. 

Older birthing people — age 40 and above — are seven times more likely to die than those birthing people under 25 at a rate of 81.9 per 100,000 live births.

It’s also important to note that, though it hasn’t been updated since 2012, the maternal mortality rate for American Indians and Alaska Natives is 45.8 deaths per 100,000 live births.

The Checkbox

The delay in collecting maternal mortality data happened in part because states aren’t required to specify whether someone died as a result of pregnancy or birth. The standard US death certificate includes a checkbox that asks if the person who died was pregnant or was within a year of giving birth, but many coroners disregard it. 

The usage of the checkbox combined with the data being analyzed leaves much room for improvement. The CDC encourages states to conduct maternal mortality reviews of deaths up to year postpartum to better understand what’s happening in different parts of the country and create a better national picture of causes of death. However, there is no requirement for states to conduct maternal mortality reviews nor is there a standardized reporting method for data collection. 

Deaths by State

Though the CDC was able to collect some data by state, it notes that the data may be unreliable because of its size and quality. 

Here are the states with the highest numbers of maternal deaths per 100,000 live births:

• Texas, 70
• California, 53
• New York, 47
• Georgia, 35
• Florida, 35

 

Do these stats piss you off? Here’s what you can do: Contact your representative and ask them to support maternal health legislation. Specifically, HR 1551/Quality Care for Moms and Babies Act, S 116/MOMS Act, the MOMMA’s Act (HR 1897/S 916), and S 1343/the Mommies Act. Find your representative here and find your Senator here.

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About the author: Casey Newman is on the board of ImprovingBirth and a PR/marketing professional with a passion for maternal issues. She enjoys spending time with her family, supporting various causes, and angrily tweeting about baseball @caseybnewman.