What’s Missing in the Effort to Stop Maternal Deaths

According to the best data available, as summarized in a report by the Centers for Disease Control and Prevention, the United States could prevent two-thirds of maternal deaths during or within a year of pregnancy.

Policies and practices to do so are well understood; we just haven’t employed them.

A first step is measuring maternal death rates, which is harder than you might think. The death needs to be directly related to the pregnancy or management of it, and confirming this requires careful data collection and assessment. Here’s a straightforward example: A death because of inadequate care during delivery would count as a maternal death, and one because of a car accident after delivery would not.

But there are trickier cases.

Early this year, the C.D.C. reported that in 2018, for every 100,000 live births, there were 17.4 maternal deaths. But this figure does not include maternal deaths from drug overdoses or suicide, so it may be an undercount.

Differences across groups

One statistic that we can be more certain of: There are large maternal mortality differences across racial and ethnic groups. The latest figures from the C.D.C. indicate that for Black women, the maternal mortality rate is 37.1 deaths per 100,000 live births. It’s less than half that, 14.7, for white women and less than one-third that, 11.8, for Hispanic women. There are also differences by region, with new mothers in rural areas facing greater threats to health than those in urban ones.

The best source of maternal mortality data comes from maternal mortality review committees, which now operate in all but a few states. They conduct case reviews to assess causes of maternal deaths.

When the C.D.C. pulled together data from 14 such committees, spanning 2008-17, it also found wide variation in death rates by race and ethnicity. For example, Black women make up about 13 percent of the female population but account for nearly 40 percent of maternal deaths.