The Centers for Disease Control and Prevention (DCD) released provisional data in April 2025 revealing an increased maternal mortality rate in 2024, as compared to 2023. This increased rate in maternal deaths, from 669 deaths (18.6 deaths per 100,000 live births) in 2023 to 688 (19 deaths per 100,000 live births) in 2024, still remains below rates in 2022 and 2021, when maternal mortality rates were at their highest in over 50 years.
A maternal death is defined by the World Health Organization as a death “from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy.”
Data from maternal mortality review committees (MMRCs), published by the CDC in August 2025 have determined the six most frequent underlying causes of pregnancy-related death:
- Mental health conditions
- Cardiovascular conditions
- Infection (including Covid-19)
- Hemorrhage
- Embolism (including amniotic fluid embolism)
- Hypertensive disorders of pregnancy
These six underlying causes accounted for over 88% of pregnancy related deaths in committee review.
Alarmingly, MMRCs also determined 84% of pregnancy-related deaths were preventable. This is highly significant, given that the United States has one of the maternal mortality rates among wealth nations.
Of note, MMRCs reviewed pregnancy-related deaths within one year of the end of pregnancy, as compared to the WHO definition of 42 days from the end of pregnancy. MMRC review also included mental health conditions, which the WHO and CDC definitions explicitly exclude under “accidental or incidental causes”, and may include suicide and overdose due to a subsance use disorder.
The leading cause of pregnancy-related death varied by race and ethnicity, with cardiac and coronary conditions as the leading cause of pregnancy-related deaths among non-Hispanic Black women, hemorrhage as the leading underlying cause of death among non-Hispanic Asian women, and mental health conditions as the leading underlying cause of death among both Hispanic and non-Hispanic white women.
Committees also determined that discrimination that contributed to up to 30% of pregnancy related deaths was reviewed, in line with statistics that show that Black women face a much higher risk of maternal death, with a 2024 average of 48.5 deaths per 100,000 live births, versus 14.8 for Asian, non-Hispanic women, 14.7 for non-Hispanic White women, and 13.4 for Hispanic women.
Future posts will discuss each of the six most frequent underlying causes in depth, highlighting standards of care and of morbidity and mortality prevention, as well as what deviations to standards of care may look like.
Questions to ask when reviewing a birth injury case:
- What underlying cause can be identified as contributing to this client’s morbidity or mortality?
- Were standards of care surrounding this underlying cause upheld in the care provided?
- Does the institution have robust systems in place for identifying and rapidly treating and contributing causes and factors?
- Are care providers properly educated about underlying causes and their effects of maternal health, morbidity and mortality?
- Could discrimination, implicit bias or inequities in maternal health, including those rooted in race and ethnicity have contributed to injury in this case?
- Could this client injury have been prevented?
Brennan Lee and Associates Nursing Consultants will help your team answer these questions and provide nursing expertise on this high-risk area of Obstetric and Birth Injury..
Contact us today!
References
Ahmad FB, Cisewski JA, Hoyert DL. Provisional Maternal Mortality Rates. National Center for Health Statistics. 2025. DOI: https://dx.doi.org/10.15620/cdc/20250305011
Center for Disease Control and Prevention (CDC). Pregnancy-Related Deaths: Data From Maternal Mortality Review Committees in 38 U.S. States,. (2025).
Center for Disease Control and Prevention (CDC). Circumstances Contributing to Pregnancy-Related Deaths: Data From Maternal Mortality Review Committees in 38 U.S. States, 2020. (2024).
Collier AY, Molina RL. Maternal Mortality in the United States: Updates on Trends, Causes, and Solutions. Neoreviews. 2019 Oct;20(10):e561-e574. doi: 10.1542/neo.20-10-e561. PMID: 31575778; PMCID: PMC7377107.
Stobbe, M. US maternal death rate rose slightly last year, health officials say. The Associated Press (2025). https://apnews.com/article/us-maternal-deaths-2024-statistics-12091a25830162 cfa005cb5c801a1c1b
World Health Organization (WHO). Maternal mortality. (2025).
