Recent Increases in the U.S. Maternal Mortality Rate: Disentangling Trends From Measurement Issues
Open accessAbstract
OBJECTIVE: To develop methods for trend analysis of vital statistics maternal mortality data, taking into account changes in pregnancy question formats over time and between states, and to provide an overview of U.S. maternal mortality trends from 2000 to 2014. METHODS: This observational study analyzed vital statistics maternal mortality data from all U.S. states in relation to the format and year of adoption of the pregnancy question. Correction factors were developed to adjust data from before the standard pregnancy question was adopted to promote accurate trend analysis. Joinpoint regression was used to analyze trends for groups of states with similar pregnancy questions. RESULTS: The estimated maternal mortality rate (per 100,000 live births) for 48 states and Washington, DC (excluding California and Texas, analyzed separately) increased by 26.6%, from 18.8 in 2000 to 23.8 in 2014. California showed a declining trend, whereas Texas had a sudden increase in 2011-2012. Analysis of the measurement change suggests that U.S. rates in the early 2000s were higher than previously reported. CONCLUSION: Despite the United Nations Millennium Development Goal for a 75% reduction in maternal mortality by 2015, the estimated maternal mortality rate for 48 states and Washington, DC, increased from 2000 to 2014; the international trend was in the opposite direction. There is a need to redouble efforts to prevent maternal deaths and improve maternity care for the 4 million U.S. women giving birth each year.
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Maternal mortality has decreased in most developed countries over the past two decades, but recent reports show it has increased in the US.
“While maternal mortality has decreased in most developed countries over the past two decades, recent reports show maternal mortality has increased in the United States (US) [2, 3].”
From Age-related disparities in national maternal mortality trends: A population-based study (2025) · cites this paper as [3]
The Discussion reports that the estimated maternal mortality rate increased in 48 states and Washington, D.C., from 2000 to 2014, while WHO reported decreases in 157 of 183 countries from 2000 to 2013. It does not establish that mortality decreased specifically in most developed countries over the past two decades. Page numbers are unavailable in our copy. (LLM, conf=0.86)
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Age-related disparities in national maternal mortality trends: A population-based study
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- Authors
- MacDorman, M. F., Declercq, E., Cabral, H., & Morton, C.
- Affiliations
- Boston University (US)
- Corresponding author
- MacDorman, Marian F.
- Venue
- Obstetrics & Gynecology
- Published
- 2016-09
- Volume
- 128
- Issue
- 3
- Pages
- 447-455
- ISSN
- 0029-7844 (ISSN-L)
- PMC
- PMC5001799
- OpenAlex
- W2515728566
- Cited by
- 487
- References
- 1
- Citations by year
- 2026: 9 · 2025: 24 · 2024: 32 · 2023: 41 · 2022: 36 · 2021: 45 · 2020: 143 · 2019: 61 · 2018: 54 · 2017: 24 · 2016: 17
- FWCI
- 60.51
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24HD041041)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- maternal mortality, maternal mortality trends, joinpoint regression, state-level trends, California, Texas, Millennium Development Goals, obstetric care, United States
- MeSH terms
- Adult, Cause of Death, Female, Humans, Maternal Mortality, Mortality, Pregnancy, United States, Perinatal Care, Live Birth, Quality Improvement, Maternal Death
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