According to the Centers for Disease Control and Prevention (CDC), there were just over 3.6 million births in the United States in 2022, with the vast majority of births occurring in hospitals. Over 10% of the births were preterm and nearly 32% were by cesarean. The CDC reports 1,205 women died from maternal causes during pregnancy or within 42 days following birth. This reflects a US maternal mortality rate that has been rising dramatically for several years, from 17.4 per 100,000 live births in 2018 to 32.9 per 100,000 live births in 2021,

There are substantial disparities by both racial/ethnic and socioeconomic status in maternal mortality. These important differences show the burden of maternal deaths is much worse in non-Hispanic Black women (69.9/100,000) compared with Hispanic women (18.0/100,000) or non-Hispanic White (26.6/100,000) women. Furthermore, in 2019 the CDC reported that maternal deaths between 42 days postpartum and the end of the first postpartum year account for about one-third of overall pregnancy-related deaths. In 2023 the CDC reported 20% of mothers who had given birth within the last 5 years reported experiencing some form of mistreatment during pregnancy or birth and almost 30% reported experiencing discrimination on the basis of race or ethnicity, age, weight, income, health insurance, or other factors.

Additionally, there are substantial disparities by racial or ethnic group or socioeconomic circumstances in pregnancy-related morbidity – for every maternal death, there are 70 cases of severe maternal morbidity (including unexpected outcomes of labor and delivery resulting in significant short- or long-term consequences to women’s health).

Based on close analyses of deaths in 36 states, the CDC estimates that approximately 80% of pregnancy-related deaths in that study, or 814 of the 1,018 deaths investigated, were potentially preventable.. This estimate is consistent with multiple studies showing that the majority (or 60-80%) of maternal deaths evaluated had at least some possible preventability, and that multiple opportunities for improvement and prevention of morbidity and mortality exist at multiple levels. In a study of the relationship between hospital birth volume and progression of severe maternal morbidity to maternal death (failure to rescue), investigators found that—after adjusting for patient characteristics and comorbidities—the hospital where the birth took place was the most important contributor to failure to rescue.

Preeclampsia

Preeclampsia is typically defined as a disorder of pregnancy associated with new-onset hypertension occurring after 20 weeks of gestation and frequently near term. The incidence of preeclampsia is estimated to occur in between 5 and 7 percent of all pregnancies, being responsible for 70,000 annual maternal deaths worldwide.

Maternal Sepsis

Maternal sepsis is defined as a life-threatening condition with organ dysfunction resulting from infection during pregnancy through 42 days postpartum. It is reported to be the second leading cause of maternal death in the US. In recent research, maternal sepsis was reported to occur in 0.04% of deliveries in the US, though 23% of maternal deaths were sepsis related.

Cardiac Dysfunction

Cardiac dysfunction is a complication referring to disorders of the cardiovascular system which may impact maternal health. The incidence of cardiac dysfunction is estimated to impact between 1% to 4% of US pregnancies and contributes with stroke to more than 34% of all pregnancy related deaths.

Source

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