About 84% of pregnancy-related deaths in the United States are preventable. That figure, drawn from state-level reviews of every maternal death, means the vast majority of the roughly 18 deaths per 100,000 live births recorded in 2024 did not have to happen. Prevention spans everything from individual health decisions and recognizing warning signs to systemic changes in how hospitals and insurance programs support pregnant and postpartum people.
When Deaths Happen: It’s Not Just Delivery Day
One of the most important things to understand is that only about 17% of maternal deaths occur on the day of delivery. The rest are split between pregnancy itself (roughly 31%) and the postpartum period (roughly 52%). That postpartum window extends well beyond the traditional six-week checkup. Many fatal complications, including heart failure, blood clots, infection, and overdose, strike weeks or months after birth, when many people have already lost regular contact with a healthcare provider.
This timing pattern reshapes what prevention looks like. It means that staying vigilant about your own health for a full year after delivery is just as critical as the care you receive during labor.
The Leading Causes You Might Not Expect
Hemorrhage and preeclampsia are well-known risks, but the single largest category of pregnancy-related death is mental health conditions. Nearly 23% of maternal fatalities are attributed to suicide or overdose, more than twice the number caused by postpartum hemorrhage. This means that treating depression, anxiety, and substance use disorders during and after pregnancy is not a secondary concern. It is the most impactful area for saving lives.
Cardiovascular disease is another major contributor. Heart conditions can emerge for the first time during pregnancy or worsen silently in the months after birth. The American College of Obstetricians and Gynecologists now endorses universal cardiovascular screening for all women during pregnancy and the postpartum period. A screening algorithm developed in California was validated against cases of women who had died from heart disease: it would have flagged 88% of those cases even when the women had no symptoms.
Warning Signs That Need Immediate Attention
Knowing the red flags can be lifesaving, both during pregnancy and for up to a year after delivery. The CDC’s Hear Her campaign identifies these urgent warning signs:
- Severe headache that won’t go away, starts suddenly, or comes with blurred vision
- Vision changes like flashes of light, blind spots, or seeing double
- Trouble breathing or chest tightness, especially if it develops suddenly
- Chest pain or a fast, irregular heartbeat
- Extreme swelling of the hands or face beyond normal pregnancy puffiness
- Fever of 100.4°F or higher
- Severe belly pain that doesn’t go away or gets worse
- Heavy vaginal bleeding (more than spotting) or foul-smelling discharge after delivery
- Severe swelling, redness, or pain in a leg or arm, which may signal a blood clot
- Overwhelming sudden fatigue that feels different from normal tiredness
- Thoughts of harming yourself or your baby
If you or someone around you dismisses these symptoms as “normal pregnancy discomfort,” push back. Many women who died from preventable causes reported symptoms that were initially minimized by those around them or even by their providers. Trust what your body is telling you.
Preventing Preeclampsia Before It Starts
Preeclampsia, a dangerous blood pressure condition, can be partially prevented with something as simple as a daily low-dose aspirin. The U.S. Preventive Services Task Force recommends 81 mg of aspirin per day starting after 12 weeks of pregnancy for anyone at high risk. High-risk factors include a prior history of preeclampsia, carrying multiples, chronic high blood pressure, diabetes (type 1 or 2), kidney disease, or autoimmune conditions like lupus.
Even if you don’t have a single high-risk factor, combinations of moderate-risk factors also qualify. These include being a first-time parent, having a BMI over 30 before pregnancy, a family history of preeclampsia in a mother or sister, being 35 or older, conceiving through IVF, or having a gap of more than 10 years between pregnancies. If several of these apply to you, bring it up with your provider early. The aspirin needs to start before 20 weeks to be effective.
How Hospitals Are Reducing Deaths
On the systems side, hospitals across the country are adopting standardized safety bundles developed by the Alliance for Innovation on Maternal Health (AIM). These bundles address specific emergencies like hemorrhage and are built around five elements: readiness (having the right supplies and protocols in place before an emergency), recognition and prevention (screening every patient for risk), response (a clear action plan when something goes wrong), reporting and systems learning (tracking outcomes to improve over time), and respectful, equitable, and supportive care.
Hospitals also use Maternal Early Warning Criteria, a set of vital sign thresholds that trigger an immediate response. A heart rate above 120 or below 50, blood pressure above 160 systolic or below 90, breathing faster than 30 times per minute, or oxygen saturation below 95% all activate a clinical review. These systems catch deterioration early, before a complication becomes fatal. If you’re delivering at a hospital, it’s reasonable to ask whether they use standardized maternal safety bundles.
Closing the Racial Gap
Black women in the United States are three times more likely to die from a pregnancy-related cause than white women. This disparity persists across income and education levels, which means it is not simply a matter of individual health choices. It reflects differences in the quality of care received, the burden of chronic conditions driven by lifelong stress and inequity, and barriers like unstable housing, transportation access, and food insecurity.
Several policy-level efforts target this gap. The CDC’s ERASE MM program supports state-level maternal mortality review committees that examine every death to identify what went wrong and what could have been different. State perinatal quality collaboratives work directly with hospitals to standardize care and reduce variation in how Black patients are treated. At a community level, programs that pair pregnant people with doulas or community health workers have shown promise in improving outcomes, particularly for women of color who may face bias in clinical settings.
Insurance Coverage After Birth
Losing health insurance shortly after delivery is a concrete, measurable threat. Historically, Medicaid coverage for pregnancy ended just 60 days after birth, cutting off care right when the majority of postpartum deaths occur. Research from the Affordable Care Act’s Medicaid expansion found that broader coverage led to a 17% reduction in hospitalizations during the first 60 days postpartum, with an additional 8% drop between 61 days and six months.
Since the 2021 American Rescue Plan, states have the option to extend Medicaid coverage through a full 12 months postpartum. As of mid-2022, 22 states and Washington, D.C., had implemented this extension, and more have followed since. If you’re covered by Medicaid, check whether your state offers the 12-month extension. That continued coverage means you can attend follow-up appointments, fill prescriptions for blood pressure or mental health medications, and get care for complications that emerge months after delivery.
What You Can Do Before and During Pregnancy
Prevention starts before conception for many people. Managing chronic conditions like hypertension, diabetes, or depression before pregnancy reduces the chance of complications. A preconception visit gives your provider a chance to adjust medications, screen for heart disease risk, and discuss your personal risk profile.
During pregnancy, attending all scheduled prenatal visits matters, but so does speaking up between visits if something feels wrong. Keep track of your blood pressure if you have access to a home monitor. Stay connected to mental health support, especially if you have a history of depression, anxiety, or substance use. After delivery, don’t treat the postpartum period as the finish line. Schedule and keep your postpartum appointments, and take any new symptom seriously for the full year after birth, not just the first six weeks.