First Data Released on Maternal Mortality in Over a Decade

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For Immediate Release: January 30, 2020

Contact: CDC, National Center for Health Statistics, Office of Communication (301) 458-4800
E-mail: paoquery@cdc.gov

NCHS released the first national data on maternal mortality in the United States since 2007 thanks to reporting changes that have gradually been implemented by all 50 states, the District of Columbia, and U.S. territories. The new data and supporting methodological comparisons are documented in three new reports.

Maternal mortality has long been a public health concern, and the ability to correctly identify and report maternal deaths has particularly been a challenge. A maternal death is defined as “the death of a woman while pregnant or within 42 days of termination of pregnancy,” but excludes those from accidental/incidental causes. Official statistics are obtained through death certificates completed by physicians and reported to the states. To promote standardization across states, NCHS periodically convenes a national consensus process that makes recommendations to the states on the content of birth and death certificates.

In 2003, a consensus process recommended that all states add a standardized “checkbox” to improve the identification of maternal deaths. Physicians were instructed to check a box for a known pregnancy in defined timeframes prior to death. Since states individually control their vital registration systems, this recommendation was implemented gradually nationwide as funding, technology, and state laws allowed. This implementation process began in 2003 and culminated in 2017, when the last state added a checkbox to their death certificate.

Some of the highlights in the new reports:

  • The maternal mortality rate in the U.S. for 2018 was 17.4 maternal deaths per 100,000 live births. This rate is higher than the last time NCHS published a national rate (12.7 in 2007), but the increase in the maternal mortality rate largely reflects changes in the way the data was collected and reported.
  • 658 women died of maternal causes in the U.S. using the 2018 coding method.
  • Wide racial/ethnic gaps exist between non-Hispanic black (37.1 per 100,000 live births), non-Hispanic white (14.7), and Hispanic (11.8) women, which is consistent with earlier data.
  • The maternal mortality rate for women aged 40 and over (81.9 per 100,000 live births) is nearly 8 times that for women under age 25 (10.6).
  • NCHS has identified instances where application of the checkbox information according to coding rules led to misclassification of maternal deaths, and NCHS is making changes in coding rules and reporting to make data more accurate.

REPORTS:

Evaluation of the Pregnancy Status Checkbox on the Identification of Maternal Deaths
The Impact of the Pregnancy Checkbox and Misclassification on Maternal Mortality Trends in the United States, 1999–2017
Maternal Mortality in the United States: Changes in Coding, Publication, and Data Release, 2018

Information on maternal mortality, public-use data and resources are available at the following website: https://www.cdc.gov/nchs/maternal-mortality/index.htm