Maternal Mortality Rates in the United States, 2021

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by Donna L. Hoyert, Ph.D., Division of Vital Statistics

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This report presents maternal mortality rates for 2021 based on data from the National Vital Statistics System. A maternal death is defined by the World Health Organization as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes” (1). Maternal mortality rates, which are the number of maternal deaths per 100,000 live births, are shown in this report by age group and race and Hispanic origin.

This report updates a previous one that showed maternal mortality rates for 2018–2020 (2). In 2021, 1,205 women died of maternal causes in the United States compared with 861 in 2020 and 754 in 2019 (2). The maternal mortality rate for 2021 was 32.9 deaths per 100,000 live births, compared with a rate of 23.8 in 2020 and 20.1 in 2019 (Table).

In 2021, the maternal mortality rate for non-Hispanic Black (subsequently, Black) women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White (subsequently, White) women (26.6) (Figure 1 and Table). Rates for Black women were significantly higher than rates for White and Hispanic women. The increases from 2020 to 2021 for all race and Hispanic-origin groups were significant.

Rates increased with maternal age. Rates in 2021 were 20.4 deaths per 100,000 live births for women under age 25, 31.3 for those aged 25–39, and 138.5 for those aged 40 and over (Figure 2 and Table). The rate for women aged 40 and over was 6.8 times higher than the rate for women under age 25. Differences in the rates between age groups were statistically significant. The increases in the rates between 2020 and 2021 for each of these age groups were statistically significant.

Data source and methods

Data are from the National Vital Statistics System mortality file (3). Consistent with previous reports, the number of maternal deaths does not include all deaths occurring to pregnant or recently pregnant women, but only deaths with the underlying cause of death assigned to International Statistical Classification of Diseases, 10th Revision code numbers A34, O00–O95, and O98–O99. Maternal mortality rates are per 100,000 live births, based on data from the National Vital Statistics System natality file. Maternal mortality rates fluctuate from year to year because of the relatively small number of these events and possibly due to issues with the reporting of maternal deaths on death certificates (4). Efforts to improve data quality are ongoing, and these data will continue to be evaluated for possible errors. Data are shown for only the three largest race and Hispanic-origin groups for which statistically reliable rates can be calculated.

References

  1. World Health Organization. International statistical classification of diseases and related health problems, 10th revision (ICD–10). 2008 ed. Geneva, Switzerland. 2009.
  2. Hoyert DL. Maternal mortality rates in the United States, 2020. NCHS Health E-Stats. 2022.
    DOI: https://doi.org/10.15620/cdc:113967.
  3. Xu JQ, Murphy SL, Kochanek KD, Arias E. Mortality in the United States, 2021. NCHS Data Brief, no 456. Hyattsville, MD: National Center for Health Statistics. 2022.
    DOI: https://dx.doi.org/10.15620/cdc:122516.
  4. Hoyert DL, Miniño AM. Maternal mortality in the United States: Changes in coding, publication, and data release, 2018. National Vital Statistics Reports; vol 69 no 2. Hyattsville, MD: National Center for Health Statistics. 2020.

Suggested citation

Hoyert DL. Maternal mortality rates in the United States, 2021. NCHS Health E-Stats. 2023.
DOI: https://dx.doi.org/10.15620/cdc:124678.

Table

Table. Number of live births, maternal deaths, and maternal mortality rates, by race and Hispanic origin and age: United States, 2018–2021

Table 1. Number of live births, maternal deaths, and maternal mortality rates, by race and Hispanic origin and age: United States, 2018-2020
Race and Hispanic origin and age 2018 2019 2020 2021
Number of live births Number of deaths Maternal mortality rate1 Number of live births Number of deaths Maternal mortality rate1 Number of live births Number of deaths Maternal mortality rate1 Number of live births Number of deaths Maternal mortality rate1
Total2 3,791,712 658 17.4 3,747,540 754 20.1 3,613,647 861 23.8 3,664,292 1,205 32.9
Under 25 907,782 96 10.6 877,803 111 12.6 825,403 114 13.8 797,334 163 20.4
 25–39 2,756,974 458 16.6 2,739,976 544 19.9 2,658,445 607 22.8 2,731,223 854 31.3
40 and over 126,956 104 81.9 129,761 98 75.5 129,799 140 107.9 135,735 188 138.5
Non-Hispanic Black3 552,029 206 37.3 548,075 241 44.0 529,811 293 55.3 517,889 362 69.9
Under 25 176,243 27 15.3 169,853 32 18.8 159,541 46 28.8 149,435 62 41.5
25–39 358,276 137 38.2 360,206 179 49.7 351,648 198 56.3 349,170 242 69.3
40 and over 17,510 42 239.9 18,016 30 166.5 18,622 49 263.1 19,284 58 300.8
Non-Hispanic White3 1,956,413 291 14.9 1,915,912 343 17.9 1,843,432 352 19.1 1,887,656 503 26.6
Under 25 391,829 41 10.5 374,129 49 13.1 348,666 40 11.5 336,792 57 16.9
25–39 1,504,888 207 13.8 1,480,595 248 16.8 1,433,839 253 17.6 1,486,249 364 24.5
40 and over 59,696 43 72.0 61,188 46 75.2 60,927 59 96.8 64,615 82 126.9
Hispanic 886,210 105 11.8 886,467 112 12.6 866,713 158 18.2 885,916 248 28.0
Under 25 275,553 21 7.6 270,948 23 8.5 258,635 20 7.7 255,806 36 14.1
25–39 579,553 72 12.4 584,109 71 12.2 576,690 111 19.2 597,703 184 30.8
40 and over 31,104 12 * 31,410 18 * 31,388 27 86.0 32,407 28 86.4

* Rate does not meet National Center for Health Statistics standards of reliability.
1Maternal mortality rates are deaths per 100,000 live births.
2Includes deaths for race and Hispanic-origin groups not shown separately, including women of multiple races and origin not stated.
3Race groups are single race.

NOTES: Maternal causes are those assigned to code numbers A34, O00–O95, and O98–O99 of the International Classification of Diseases, 10th Revision. Maternal deaths occur while pregnant or within 42 days of being pregnant.

SOURCE: National Center for Health Statistics, National Vital Statistics System, Natality and Mortality.

Figures

Figure 1. Maternal mortality rates, by race and Hispanic origin: United States, 2018–2021

This is a bar chart of the maternal mortality rates by single race and Hispanic origin. The rates are greater for non-Hispanic Black women compared with non-Hispanic White and Hispanic women. The increase between 2020 and 2021 is statistically significant for non-Hispanic Black women, non-Hispanic White women, Hispanic women, and total women.
1Statistically significant increase from previous year (p < 0.05).
NOTE: Race groups are single race.
SOURCE: National Center for Health Statistics, National Vital Statistics System, Mortality.

Figure 2. Maternal mortality rates, by age group: United States, 2018–2021

This is a bar chart of the maternal mortality rates by age. The rates increase with increasing age. The increase between 2020 and 2021 is statistically significant for women age under 25, 25–39, and 40 and over.
1Statistically significant increase from previous year (p < 0.05).
SOURCE: National Center for Health Statistics, National Vital Statistics System, Mortality.