Four out of five pregnancy-related deaths in the US are preventable
More than 80% of pregnancy-related deaths were preventable, according to 2017-2019 data from the Maternal Mortality Review Committees (MMRCs), which are representatives from diverse clinical and non-clinical backgrounds who review the circumstances surrounding pregnancy-related deaths to make recommendations about future ones prevent deaths. Information from MMRCs in 36 US states on the leading causes of death by race and ethnicity can be used to prioritize actions that can save lives and reduce health disparities.
“The report paints a much clearer picture of pregnancy-related deaths in this country,” said Wanda Barfield, MD, MPH, director of the CDC Division of Reproductive Health at the National Center for Chronic Disease Prevention and Health Promotion. “The majority of pregnancy-related deaths were preventable, underscoring the need for quality improvement initiatives in states, hospitals and communities that ensure all pregnant or postpartum people receive the right care at the right time.”
Of the pregnancy-related deaths with timing information, 22% of deaths occurred during pregnancy, 25% on the day of delivery or within 7 days thereafter, and 53% between 7 days and 1 year after pregnancy.
The leading causes of pregnancy-related deaths include:
- Mental illness (including suicide and drug overdose/poisoning related deaths) (23%)
- Excessive bleeding (hemorrhage) (14%)
- Heart and coronary diseases (related to the heart) (13%)
- infection (9%)
- Thrombotic embolism (a type of blood clot) (9%)
- Cardiomyopathy (a disease of the heart muscle) (9%)
- Hypertensive pregnancy disorders (related to high blood pressure) (7%)
The most common underlying cause of death varied by race and ethnicity. Heart and heart disease were the leading underlying cause of pregnancy-related deaths among non-Hispanic Black people, mental illness was the leading underlying cause for Hispanic and non-Hispanic White people, and bleeding was the leading underlying cause for non-Hispanic Asian individuals.
Highlighted dates of American Indians or Alaskan Natives
Native Americans or Alaskan Natives (AI/AN) are disproportionately affected by pregnancy-related deaths. A second report uses an approach to classifying AI/AN populations that also includes those who also identify as multiracial or Hispanic.
Based on a review of pregnancy-related deaths in AI/AN individuals, mental illness and bleeding were the most common underlying causes of death, accounting for 50% of deaths with a known underlying cause. Most pregnancy-related deaths among AI/AN individuals (93%) were classified as preventable. About 64% of deaths occurred between 7 days and 1 year after pregnancy.
Everyone can help prevent pregnancy-related deaths
More than half (53%) of pregnancy-related deaths occur within a year of delivery. It is critical for all healthcare professionals to ask if their patient is pregnant or has been pregnant in the last year in order to make diagnostic and treatment decisions. Health systems, communities, families and other support systems need to be aware of the serious pregnancy-related complications that can arise during and after pregnancy. Hear the concerns of people who are pregnant and have been pregnant in the last year and help them get the care they need.
Examples of prevention recommendations from MMRCs include broader access to insurance coverage to improve initiation of prenatal care and post-pregnancy follow-up, opportunities to avoid barriers to transport to care, and the need for referral and coordination systems.
Maternal mortality review commissions are the best source for prevention strategies
MMRCs are multidisciplinary committees that meet at the state or local level to comprehensively review deaths during or within a year of pregnancy. Their goal is to understand the circumstances of each death and develop recommendations for action to prevent deaths in the future.
This is the first information to be released as part of Enhancing Reviews and Surveillance to Eliminate Maternal Mortality, a CDC-funded program to support agencies and organizations that administer MMRCs. CDC also supports the Maternal Mortality Review Information Application (MMRIA) to standardize the reporting of data from MMRCs. This report reflects the efforts made by jurisdictions to improve their MMRC processes and use MMRIA to document and disseminate information.
Recently, CDC significantly increased its investment in efforts to eliminate preventable pregnancy-related deaths, with new grants totaling $2.8 million to support additional MMRCs in nine jurisdictions. CDC now supports MMRCs in 39 states and one US territory. Building this important infrastructure will help better understand and prevent pregnancy-related deaths in the United States
State Strategies for Preventing Pregnancy-Related Deaths: A Guide for MMRC Data to Action provides MMRCs and their partners with guidance to facilitate the implementation of data-driven strategies to prevent pregnancy-related deaths.