Report: Maternal Mortality Rates More Than Doubled Between 1999, 2019

SEATTLE — The number of U.S. women who died within a year after pregnancy more than doubled between 1999 and 2019, with the highest death rate being experienced by Black and Native American women, according to researchers at the University of Washington, Seattle, and Massachusetts General Hospital in Boston.

The study, which was published in the Journal of the American Medical Association, found that in most states maternal deaths per 100,000 live births was higher among American Indian and Alaska Native and Black populations than among Asian, Native Hawaiian or other Pacific Islander, Hispanic and White populations. 

Between 1999 and 2019, observed median state maternal deaths increased from 14 to 49.2 per 100,000 live births among the American Indian and Alaska Native population, 26.7 to 55.4 per 100,000 live births among the Black population, 9.6 to 20.9 per 100,000 live births among the Asian, Native Hawaiian or other Pacific Islander population, and 9.6 to 19.1 per 100,000 live births among the Hispanic population.

Meanwhile the median state number of maternal deaths rose from 9.4 to 26.3 among the White population. 

In each year between 1999 and 2019, the researchers said the Black population had the highest median state maternal mortality rate, while the American Indian and Alaska Native population saw the largest increases in median state maternal mortality rate during that period.

“While maternal mortality remains unacceptably high among all racial and ethnic groups in the U.S., American Indian and Alaska Native and Black individuals are at increased risk, particularly in several states where these inequities had not been previously highlighted,” the researchers wrote. 

“Median state MMRs for the American Indian and Alaska Native and Asian, Native Hawaiian or other Pacific Islander populations continue to increase, even after the adoption of a pregnancy checkbox on death certificates. Median state MMR for the Black population remains the highest in the U.S. 

“Comprehensive mortality surveillance for all states via vital registration identifies states and racial and ethnic groups with the greatest potential to improve maternal mortality. Maternal mortality persists as a source of worsening disparities in many U.S. states and prevention efforts during this study period appear to have had a limited impact in addressing this health crisis,” the authors concluded.

The authors include Laura G. Fleszar, MPH, Catherine O. Johnson, MD, MPH, and Laura Dwyer-Lindgren, MPH, Ph.D., all of the Institute for Health Metrics and Evaluation, University of Washington, Seattle, and others.

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