CDC Says 4 Out of 5 Pregnancy-Related Deaths Are Preventable

It is unfortunately not news that the U.S. has one of the highest maternal mortality rates among high-income nations. But findings released from The Centers for Disease Control and Prevention (CDC) in Sept. 2022 show that 4 out of 5 pregnancy-related deaths are likely preventable.

In examining 1,018 pregnancy-related deaths in 36 states between 2017 and 2019 (the most recent data available), researchers found that in 84% of cases, a death could have been prevented had the provider or larger community taken additional steps or if healthcare access had been expanded.

Pregnancy-related deaths can occur anytime during pregnancy or birth, or up to one year after birth from a pregnancy complication. The report found that more than half (53%) of these preventable deaths occurred up to 12 months after birth, which indicates a strong need for more maternal follow-up visits after delivery. The six-week postpartum check-up simply isn’t enough.

“The report paints a much clearer picture of pregnancy-related deaths in this country,” said Wanda Barfield, MD, MPH, director of CDC’s Division of Reproductive Health at the National Center for Chronic Disease Prevention and Health Promotion, in a press release. “The majority of pregnancy-related deaths were preventable, highlighting the need for quality improvement initiatives in states, hospitals, and communities that ensure all people who are pregnant or postpartum get the right care at the right time.”

The maternal mortality rate keeps growing

The 2022 report also highlights that not all communities receive the same level of maternal care, and as a result, the mortality rate is trending in the wrong direction.

In 2018, the maternal mortality rate was 17.4 deaths per 100,000 live births, and in 2020 it was 23.8 deaths per 100,000 live births, with Black and Indigenous communities among the most impacted.

The most recent statistics highlight that in 2021, the number of U.S. women dying from pregnancy-related issues rose a whopping 40% from the year prior, a 2023 report from Centers for Disease Control and Prevention (CDC) shows, suggesting that the pandemic dramatically worsened the maternal mortality rate. And though the increase was significant across all racial and ethnic groups, Black women were 2.6 times more likely to die than white women and 2.5 times more likely to die than Hispanic women.

Still, Covid isn’t the only contributing factor when it comes to maternal mortality. “The COVID-19 pandemic had a dramatic and tragic effect on maternal death rates, but we cannot let that fact obscure that there was—and still is—already a maternal mortality crisis to compound,” The American College of Obstetricians and Gynecologists (ACOG) President Dr. Iffath Abbasi Hoskins said in a statement.

“Due to systemic racism and discrimination at the individual level, Black women and birthing people face unacceptable (and mostly preventable) risk during childbirth and throughout and after pregnancy,” writes The Century Foundation.

What are common causes of maternal mortality?

The 2022 CDC report states that the primary cause of pregnancy-related deaths are due to mental health conditions. That may include death by suicide, overdose or a substance use disorder.

Other causes of pregnancy-related death include:

Hemorrhage
Cardiac and coronary conditions
Infection
Blood clots
High blood pressure
Cardiomyopathy
Cancer

The complete list can be viewed here.

It’s also important to note that the majority of maternal deaths occur after delivery. Approximately 22% of deaths occurred during pregnancy, 25% occurred on the day of delivery (within 24 hours of the end of pregnancy) or within a week after delivery, 23% occurred from 7 to 42 days postpartum, and 30% occurred in the late postpartum period (43–365 days postpartum).

Women who have recently given birth must be made aware of the signs and symptoms that might signal something’s wrong. The CDC shares a helpful list.

Urgent maternal warning signs include but are not limited to:

Headache that won’t go away or gets worse over time
Dizziness or fainting
Changes in vision
Fever above 100.4ºF
Extreme swelling of hands or face
Thoughts about harming yourself or your baby
Trouble breathing
Chest pain or a racing heart
Severe nausea and vomiting

If you gave birth within the past year and experience any of the above, seek emergency medical care immediately.

More provider support

However, the onus shouldn’t only fall to pregnant people or new mothers to advocate for their own care in the days, weeks and months after giving birth. The authors of the CDC report stress the importance of the need for increased healthcare visits, more screening protocols and better insurance coverage for postpartum care.

ACOG advocates for at least one visit to an OBGYN or midwife within the first 3 weeks after delivery, with a comprehensive visit no later than 12 weeks, but the CDC stresses that the burden should fall to all healthcare providers—not just birth providers.

“It is critical for all healthcare professionals to ask whether their patient is pregnant or has been pregnant in the last year to inform diagnosis and treatment decisions. Healthcare systems, communities, families, and other support systems need to be aware of the serious pregnancy-related complications that can happen during and after pregnancy,” notes the agency in a press statement.

“Listen to the concerns of people who are pregnant and have been pregnant during the last year and help them get the care they need.”

A version of this story was originally published on Sept. 23, 2022. It has been updated.