Maternal mortality refers to the death of a person during pregnancy, childbirth, or within 42 days after the end of a pregnancy, from causes related to or worsened by the pregnancy itself. The World Health Organization excludes accidental or incidental causes from this definition, meaning only deaths tied to the physical demands of pregnancy or how it was managed count toward the official numbers. More than 80% of these deaths are preventable, according to the CDC, which makes the persistence of maternal mortality one of the most urgent problems in global health.
How Maternal Mortality Is Measured
The standard measure is the maternal mortality ratio: the number of maternal deaths per 100,000 live births in a given year. This ratio lets researchers compare countries and populations of very different sizes. A country with 10 maternal deaths per 100,000 live births has a fundamentally different healthcare landscape than one with 500, and the ratio makes that gap visible at a glance.
The 42-day cutoff matters because many fatal complications, like postpartum bleeding or infections, develop in the weeks after delivery rather than during labor itself. Some health systems also track “late maternal deaths,” which occur between 42 days and one year after pregnancy ends. These later deaths capture conditions like heart failure that may take months to become fatal but were triggered or worsened by pregnancy. However, the standard global statistics use the 42-day window.
Leading Causes of Maternal Death
The causes fall into two broad categories: direct obstetric causes, meaning complications of pregnancy itself, and indirect causes, meaning pre-existing conditions that pregnancy makes worse.
Severe bleeding (hemorrhage) is the single largest killer, responsible for roughly 27% of maternal deaths worldwide between 2009 and 2020. Most of this bleeding happens after delivery, when the uterus fails to contract properly or when tissue is retained. It can become life-threatening within minutes, which is why access to emergency care and blood transfusions is so critical. Hypertensive disorders, including dangerously high blood pressure and preeclampsia, account for about 16% of deaths. These conditions can cause seizures, organ damage, and stroke if not detected and managed during prenatal visits. Infections acquired during or after delivery remain another major cause globally.
Indirect causes include heart disease, diabetes, HIV, malaria, and other chronic conditions that may have been stable before pregnancy but become dangerous under the cardiovascular and metabolic strain of carrying a child. In wealthier countries where obstetric hemorrhage is more survivable, heart-related conditions have become a leading contributor to maternal death.
Racial Disparities in the United States
The United States has one of the highest maternal mortality rates among wealthy nations, and the burden is not shared equally. In 2023, the maternal mortality rate for Black women was 50.3 deaths per 100,000 live births. For White women, it was 14.5. For Hispanic women, 12.4. For Asian women, 10.7. That means Black women died at roughly three and a half times the rate of White women and nearly five times the rate of Asian women.
These gaps persist even when researchers control for income and education. A Black woman with a college degree still faces higher risk than a White woman without one. The reasons are layered. Systemic racism shapes where people live, what hospitals they deliver in, how their symptoms are interpreted by providers, and whether warning signs get followed up on. Research from the National Institutes of Health describes a “web of missed opportunities” in which unequal access to care, delayed diagnoses, unrecognized warning signs, and failed communication between patients and providers compound each other. Bias during referral processes and follow-up appointments can mean that even properly identified risk factors like high blood pressure or cardiovascular disease go inadequately treated.
Social Factors That Drive Risk
Maternal mortality is not purely a medical problem. The conditions in which someone lives, works, and accesses care shape their risk long before they arrive at a hospital. Socioeconomic status, education level, neighborhood environment, employment stability, and social support networks all influence whether a pregnant person gets timely prenatal screening, whether risk factors like preeclampsia or gestational diabetes get caught early, and whether follow-up care actually happens after delivery.
Lack of stable housing, food insecurity, and incarceration all reduce the likelihood that someone will be screened for the medical risk factors most closely tied to maternal death. Cumulative stress from discrimination and marginalization takes a biological toll as well, contributing to chronic conditions like hypertension that make pregnancy more dangerous. In rural areas, the closure of maternity units forces people to travel long distances for care, delaying treatment when minutes count. The gap between a textbook-safe pregnancy and a real one often comes down to whether the systems around a person are functioning or failing.
Global Targets and Progress
The United Nations set a Sustainable Development Goal of reducing the global maternal mortality ratio to fewer than 70 deaths per 100,000 live births by 2030. Progress has been uneven. Countries that invested in training midwives, expanding access to emergency obstetric care, and improving blood supply infrastructure have seen steep declines. Sub-Saharan Africa and South Asia still carry the vast majority of the global burden, largely because of gaps in healthcare infrastructure, skilled birth attendants, and access to contraception.
The interventions that prevent maternal death are well established: prenatal care that catches high blood pressure and infections early, skilled attendants at every birth, access to emergency surgery and blood transfusions, and postpartum monitoring in the weeks after delivery. The challenge is not medical knowledge. It is delivering that knowledge consistently to every person who needs it, regardless of where they live, what they look like, or how much money they have.