Maternal Mortality Isn’t Skyrocketing: A Reassuring Look at the Real Numbers

As a maternal mental health specialist, I talk to a lot of moms-to-be and new moms who are worried about their health—and honestly, who wouldn’t be with all the headlines screaming about rising maternal mortality rates in the U.S.? It’s scary to hear numbers like 32.9 deaths per 100,000 live births in 2021 tossed around, making it sound like pregnancy is getting riskier by the day. But I’ve got some good news to share: a recent study shows that maternal mortality isn’t actually increasing, despite what you might’ve heard. Let’s unpack this together and ease some of that worry.

Healthy mom and baby!

What the Headlines Get Wrong

You’ve probably seen reports saying maternal deaths jumped from 17.4 in 2018 to 23.8 in 2020, and up to 32.9 per 100,000 live births in 2021, according to the National Vital Statistics System (NVSS). It sounds alarming, and it’s easy to think something’s gone terribly wrong with maternity care. But a study published in the American Journal of Obstetrics & Gynecology (Joseph et al., 2024) digs into these numbers and finds a different story. The real issue? How we’re counting these deaths.

Back in 2003, death certificates added a “pregnancy checkbox” to flag if a woman was pregnant or recently postpartum when she died. It's a great idea in theory, but it’s led to some big mistakes. Think about it: women over 70 being marked as pregnant, or deaths from car accidents and cancer getting labeled as “maternal” just because the box was checked. These are what the study calls “indirect” or “incidental” causes—things not directly tied to pregnancy itself—and they’ve been inflating the numbers.

The Real Picture: Stable Rates, Better Outcomes

Here’s the reassuring part. When the researchers looked closer, using a stricter method—counting only deaths where pregnancy was listed as a cause, not just a checkbox—they found maternal mortality is actually stable. From 1999–2002 to 2018–2021, the rate hovered around 10.2 to 10.4 per 100,000 live births. Not soaring, not crashing—just steady. And even better? Deaths from direct obstetrical causes—like bleeding, preeclampsia, or infections—dropped by 17% over that time. That’s huge! It means for all women, no matter their background or race, the risks tied directly to pregnancy and childbirth are going down, thanks to better care and medical advances.

Why the Numbers Look Higher

So why do the stats look so grim? The study points to those indirect causes—like heart conditions or accidents—being lumped in with true maternal deaths. The checkbox was meant to catch more cases, but it’s snagged a lot of unrelated ones too. For example, maternal deaths tied to cancer shot up 46-fold when the checkbox was used, even though pregnancy didn’t cause those deaths. Same with stuff like COVID-19 or hypertension not directly linked to being pregnant. When you peel those away, the picture’s clearer: maternal mortality isn’t spiraling out of control!

What This Means for You

I know pregnancy can feel overwhelming, and these inflated numbers don’t help. But as someone who works with moms every day, I want you to hear this: the risks of dying from pregnancy itself are not climbing. Direct maternal mortality—the stuff we most worry about, like complications during birth—is actually decreasing for all women. That’s the heart of this study, and it’s a win worth celebrating. Yes, we still have work to do—some women face higher risks from chronic health issues, and we need to keep improving care for everyone—but the popular notion of a maternal mortality crisis? It’s more noise than truth.

So, take a deep breath. You’re not stepping into a riskier world when you have a baby. The data’s been muddied by sloppy counting, but when we clear it up, it’s steady and even improving where it counts most. You’ve got this, and science backs that up.

Reference

• Joseph, K. S., et al. (2024). Maternal mortality in the United States. American Journal of Obstetrics & Gynecology. https://doi.org/10.1016/j.ajog.2023.12.038

  
  

Disclaimer: This is my opinion as a maternal mental health specialist, meant for education and reassurance—not medical advice. Every pregnancy’s unique, so always chat with your healthcare provider about your specific needs!