Pregnancy is a common, generally survivable experience, but it carries real medical risks that are higher than many people expect. In the United States, roughly 17 out of every 100,000 people who give birth die from pregnancy-related causes. That number is low in absolute terms, but it’s more than double the rate in most other high-income countries, and it doesn’t capture the much larger group of women who survive serious, sometimes life-altering complications. For every maternal death, there are 70 to 80 cases of severe illness at the time of birth alone.
The Numbers in Context
About 3.6 million births happen in the U.S. each year. Roughly 50,000 to 60,000 of those involve what’s called severe maternal morbidity: unexpected complications during labor or delivery with serious short- or long-term health consequences. That works out to about 1.4% of all deliveries, or roughly 1 in 70. These complications range from emergency blood transfusions and organ failure to emergency hysterectomy.
Globally, the picture varies enormously depending on where you live. The worldwide maternal mortality ratio is 197 deaths per 100,000 live births. In high-income countries, it averages about 10 per 100,000. In low-income countries, it’s 346 per 100,000. Put another way: a 15-year-old in a high-income country has about a 1 in 7,933 lifetime chance of dying from a pregnancy-related cause. In a low-income country, that number is 1 in 66.
What Actually Kills People
The leading causes of pregnancy-related death have shifted over time. In the most recent U.S. data from 2021, the breakdown looks like this:
- Infection (33.2% of deaths): This was heavily influenced by COVID-19, which alone accounted for nearly 28% of all pregnancy-related deaths that year. Even setting aside the pandemic, infections including sepsis are consistently one of the top threats, responsible for about 11% of maternal deaths worldwide.
- Mental health conditions (22.5%): This includes suicide and drug overdoses. Suicide during or within one year of pregnancy contributes to about 8.4% of pregnancy-related deaths. More than 80% of these mental health deaths are considered preventable.
- Cardiovascular conditions (10.4%): Heart-related problems, including a form of heart failure called cardiomyopathy, are a persistent and growing cause of maternal death.
- Hemorrhage (8.7%): Severe bleeding, particularly after delivery, is the leading cause of maternal death globally, accounting for over 20% of maternal deaths worldwide. In the U.S., improved hospital protocols have reduced its share, but it still affects millions of women each year.
- Blood clots (5.3%) and high blood pressure disorders (3.5%) round out the remaining major causes.
Preeclampsia and High Blood Pressure
Preeclampsia, a condition involving dangerously high blood pressure, affects 3% to 8% of pregnancies worldwide. It typically develops after 20 weeks and can progress rapidly. In its most severe form, it causes seizures (eclampsia), organ damage to the kidneys, liver, and brain, and a dangerous drop in blood-clotting cells. It can also trigger the placenta to separate from the uterine wall, cutting off oxygen to the baby.
What makes preeclampsia particularly important is that its effects don’t end at delivery. Women who develop preeclampsia have a two- to four-fold higher risk of cardiovascular disease later in life compared to women with normal blood pressure during pregnancy. The risk of developing chronic high blood pressure, heart disease, and stroke before age 55 increases by 1% to 2% for each additional day between a preeclampsia diagnosis and delivery. So a more severe, longer-lasting case carries a larger long-term toll on the heart and blood vessels.
The Mental Health Dimension
Mental health conditions are the second leading cause of pregnancy-related death in the U.S., a fact that surprises many people. This category includes postpartum depression severe enough to lead to suicide, as well as overdose deaths tied to substance use disorders. These deaths often happen weeks or months after delivery, well past the point when most medical attention has ended.
A CDC review of data from 36 states found that more than 80% of all maternal deaths were preventable, including 23% of deaths from mental health conditions specifically. The gap between the end of obstetric care and the start of ongoing mental health support is where many of these deaths occur.
Who Faces the Highest Risk
Pregnancy risk is not evenly distributed. Age, race, and pre-existing health conditions all play significant roles.
Age
Being 35 or older at the time of pregnancy is considered a moderate risk factor for preeclampsia, and the risk of complications rises on a continuum with each additional year. Chronic conditions like diabetes, high blood pressure, and obesity become more common with age and compound pregnancy-related risks. Researchers now typically break down risk in five-year increments (35 to 39, 40 to 44, 45 to 49, 50 and older) because the jump from the late 30s to the mid-40s is substantial. The risk of chromosomal abnormalities in the baby also increases significantly after 35.
Race and Ethnicity
In 2021, Black women in the U.S. died at a rate of 69.9 per 100,000 live births, 2.6 times the rate for white women (26.6 per 100,000). American Indian and Alaska Native women face similarly elevated risks. These disparities persist even after controlling for income and education, pointing to systemic differences in how care is delivered, how symptoms are taken seriously, and how chronic stress affects health over a lifetime. Asian and Latina women have lower rates overall but have also seen increases over the past two decades.
Complications That Linger After Delivery
Some of the most important risks of pregnancy aren’t immediate. They show up years later. Women who had preeclampsia carry that two- to four-fold elevated cardiovascular risk for the rest of their lives. Gestational diabetes, which resolves after birth, is associated with roughly 2.5 times the risk of later cardiovascular disease compared to women who maintained normal blood sugar during pregnancy.
These aren’t abstract statistical findings. They mean that a healthy 30-year-old who develops preeclampsia or gestational diabetes during pregnancy has a meaningfully higher chance of a heart attack or stroke in her 40s or 50s than she otherwise would. Knowing this can change how you and your doctor approach screening and prevention in the decades after pregnancy.
How the U.S. Compares
The U.S. maternal mortality rate of roughly 17 per 100,000 is far higher than peer nations. Most Western European countries, along with Canada, Australia, and Japan, hover around 5 to 10 per 100,000. The U.S. rate has been climbing in recent decades even as most other wealthy nations have seen theirs fall. Higher rates of chronic disease, uneven access to prenatal care, racial disparities in treatment, and a fragmented healthcare system all contribute.
The preventability finding is worth repeating: maternal mortality review committees across 36 states concluded that more than 80% of pregnancy-related deaths could have been prevented. That’s not a statement about pregnancy being inherently safe. It’s a statement about how many deaths result from gaps in the system rather than from unavoidable biology.