Understanding Maternal Mortality in the United States: What the Data Reveals

By Birth & Baby University · Last updated: October 2026 · 9 min read

“Maternal mortality” sounds like a single number, but the United States publishes several, built on different definitions, different data sources and different time windows. For a doula, the differences matter. They explain why two accurate headlines can disagree, what the figures can and cannot say about the families you serve, and where a non-clinical support person is positioned in a system that review committees describe as largely able to prevent these deaths. This article walks through what the national data reveal, where they are uncertain, and what that means for doula practice.

Key takeaways

Quick answer: the National Center for Health Statistics (NCHS) counted 649 maternal deaths in the United States in 2024, a rate of 17.9 per 100,000 live births. That was not a significant change from 2023, and the rate for Black non-Hispanic women remained more than three times the rate for White non-Hispanic women.

• NCHS counts deaths during pregnancy or within 42 days of its end. The Centers for Disease Control and Prevention (CDC) review committees look at deaths up to one year after pregnancy, and they report different causes and timing.
• In committee data from 36 states for 2017 to 2019, more than 80 percent of pregnancy-related deaths were judged preventable, and just over half occurred between seven days and one year after the end of pregnancy.
• Counts depend on how deaths are recorded. Research on the pregnancy checkbox on death certificates shows that recording practices can change measured rates.
• Doulas do not diagnose or treat. The data support a narrower job: know the warning signs, keep postpartum follow-up on the family’s radar, and refer quickly.

Three terms that are often mixed up

NCHS defines a maternal death as the death of a woman while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. Its figures come from the National Vital Statistics System, which is based on death certificates.

The CDC’s Maternal Mortality Review Committees (MMRCs) use a different definition. A pregnancy-related death is a death during pregnancy or within one year of the end of pregnancy from a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy. Committees review the case in detail instead of relying on a code.

So the NCHS rate and the committee findings answer different questions. The first is a surveillance rate based on a 42-day window. The second is a case review that includes the whole first year, and it is the source of the data on timing, causes and preventability.

What the national rates show

In NCHS Health E-Stat 113 (March 2026), Donna Hoyert reports 649 maternal deaths in 2024 compared with 669 in 2023. The 2024 rate was 17.9 per 100,000 live births, against 18.6 in 2023, and the report describes the change as not significant. The rates varied widely by group:

• By race and Hispanic origin (2024): 44.8 for Black non-Hispanic women, 18.1 for Asian non-Hispanic women, 14.2 for White non-Hispanic women and 12.1 for Hispanic women.
• By age (2024): 13.7 for women under 25, 16.5 for ages 25 to 39, and 62.3 for ages 40 and older.

The report notes that rates fluctuate because the number of events is relatively small, and possibly because of issues with the accuracy of reporting maternal deaths on death certificates. A one-year dip or rise should not be read as a trend.

Age patterns have been studied separately. A 2021 analysis by MacDorman and colleagues of 2016 and 2017 data found rates twice as high for women aged 35 to 39, four times as high for ages 40 to 44 and 11 times as high for ages 45 to 54, compared with women under 35. Obstetric hemorrhage was the leading cause for women 35 and older, followed by postpartum cardiomyopathy. The authors concluded that much of the excess mortality is preventable and that early detection and continued care through the postpartum year are critical.

What review committees add

CDC’s September 2022 release on MMRC data from 36 states for 2017 to 2019 reported that more than 80 percent of pregnancy-related deaths were preventable. It also described timing: 22 percent occurred during pregnancy, 25 percent on the day of delivery or within seven days, and 53 percent between seven days and one year after the end of pregnancy. The leading underlying causes were mental health conditions (23 percent), excessive bleeding (14 percent) and cardiac conditions (13 percent), followed by infection and blood clots (9 percent each) and hypertensive disorders (7 percent). Leading causes differed by group. Cardiac conditions led for non-Hispanic Black people, mental health conditions for Hispanic and non-Hispanic White people, and hemorrhage for non-Hispanic Asian people. CDC reported that 93 percent of pregnancy-related deaths among American Indian and Alaska Native people were preventable.

A later CDC report on 2020 data (published May 2024) covered 525 pregnancy-related deaths across 38 states. Committees judged that discrimination contributed to 30 percent of deaths, obesity to 32 percent, mental health conditions to 26 percent and substance use disorder to 25 percent (counting both “yes” and “probably”). The same report states that in some states only a partial year of data was shared, and that some states may have reviewed only selected causes before reporting.

Why the data are hard to read

• Recording practices change counts. A 2022 study by Rossen and colleagues examined the pregnancy status checkbox, which states adopted gradually. It estimated that adopting the checkbox raised measured rates substantially, by 76 percent in large urban areas and by 107 percent in rural areas, and that trends and urban-rural differences were much smaller when analyses were limited to direct causes of maternal death, which are probably less prone to misclassification.
• Windows differ. A 42-day count omits deaths later in the first year. Committee data capture those deaths, but they come from a subset of states, and the number of participating states changed from year to year (36 in the 2017 to 2019 analysis, 38 in the 2020 report).
• “Preventable” is a committee judgment. It is the judgment a committee reaches after reviewing a case, not a measured effect of any specific intervention. It does not say that a particular service, including doula care, would have changed an individual outcome.
• Small numbers. Rates for smaller groups can swing from year to year, which NCHS itself cautions about.

What this means for doulas

The data do not make doulas clinicians, and they do not prove that doula support lowers maternal mortality. None of the sources cited here tests whether doula care changes mortality. What the numbers do support is attention to a few things that sit inside a doula’s usual scope.

• The postpartum period is when many deaths occur. More than half of the 2017 to 2019 pregnancy-related deaths came between seven days and one year after the end of pregnancy. Postpartum doulas and birth doulas who stay in touch after birth see families at exactly that time.
• Warning signs. CDC’s Hear Her campaign lists urgent maternal warning signs that apply during pregnancy and in the year after delivery. Examples include a headache that will not go away, trouble breathing, chest pain or a fast-beating heart, a fever of 100.4°F or higher, vaginal bleeding or discharge after pregnancy, and thoughts about harming yourself or your baby. The page says the list is not meant to cover every symptom and advises seeking care immediately if these occur.
• Mental health is part of the picture. Mental health conditions were the leading underlying cause in the 2017 to 2019 committee data. A doula can be a trusted person to whom a parent says how they are really doing, and can encourage that parent to speak to their clinician.
• Believing the client. Committee findings include discrimination as a contributing circumstance. Listening, documenting what the client reports and helping them put concerns into words for the care team are within scope.

Putting it into practice

1. Give each client a written list of urgent warning signs from a reputable source, and ask them to share it with their partner or support person.
2. At postpartum contacts, ask open questions about sleep, mood, pain, bleeding and breathing, and note anything that sounds like a warning sign.
3. If a client describes a warning sign, say plainly that it needs prompt medical attention, help them contact their clinician or emergency services, and do not offer a diagnosis or reassurance about the cause.
4. Encourage clients to attend postpartum visits and to say if they cannot get to one, so you can help them find options.
5. Learn who in your area offers postpartum care and behavioral health services, so a referral is specific. Our related article on recognizing when to refer covers the practice side.

Limits and uncertainty

This article draws on national statistics and committee reports whose methods have limits. Rates depend on how deaths are certified and counted. Committee data come from participating states, not the whole country, and the preventability finding is a judgment made after review. Neither data set tests whether doula care changes mortality, and the article makes no claim that it does. Figures also age: check the latest NCHS and CDC releases before quoting any number.

The bottom line

The United States still records hundreds of maternal deaths each year, with sharp differences by race and age. Review committees judge most pregnancy-related deaths to be preventable, and many occur after the first week postpartum. Doulas cannot treat these conditions, but they can help families recognize warning signs, speak up and reach care.

Birth & Baby University’s For Doulas page outlines its online, self-paced birth and postpartum doula training, recertification and mentorship. If you are building the skills to support families before and after birth, it is a good place to see where you fit.

This article is for professional education. It is not medical, legal, financial or tax advice. Check the standards of your certifying organization and the rules where you work.

Sources and further reading

• Hoyert DL. Maternal Mortality Rates in the United States, 2024. NCHS Health E-Stats 113 (March 2026). Read the source
• Centers for Disease Control and Prevention. Four in 5 pregnancy-related deaths in the U.S. are preventable (press release, September 19, 2022; MMRC data from 36 states, 2017 to 2019). Read the source
• Centers for Disease Control and Prevention. Circumstances Contributing to Pregnancy-Related Deaths: Data From Maternal Mortality Review Committees in 38 U.S. States, 2020 (May 2024). Read the source
• Rossen LM, Ahrens KA, Womack LS, Uddin SFG, Branum AM. Rural-urban differences in maternal mortality trends in the United States, 1999-2017: accounting for the impact of the pregnancy status checkbox. American Journal of Epidemiology (2022). Read the source
• MacDorman MF, Thoma M, Declercq E, Howell EA. Causes contributing to the excess maternal mortality risk for women 35 and over, United States, 2016-2017. PLOS ONE (2021). Read the source
• Centers for Disease Control and Prevention. Urgent Maternal Warning Signs (Hear Her campaign; page last reviewed May 15, 2024). Read the source

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