The United States has the highest maternal mortality rate of any high-income country. In 2024, roughly 17.9 women died for every 100,000 live births, a rate that is double or triple that of most peer nations. What makes this statistic especially striking is that more than 80% of these deaths are considered preventable.
How the US Compares to Other Wealthy Nations
Among the 38 member countries of the Organisation for Economic Co-operation and Development (OECD), the United States consistently sits at the bottom of the list for maternal survival. The average maternal mortality rate across high-income countries is about 10 deaths per 100,000 live births. The US rate is nearly double that. Countries like Norway, the Netherlands, and Australia report rates in the low single digits.
Globally, the picture shifts. Low-income countries average 346 maternal deaths per 100,000 live births, and over 90% of all maternal deaths worldwide occur in low- and lower-middle-income countries. So the US is far from the worst in absolute terms. But among countries with comparable wealth, medical technology, and trained healthcare professionals, it is a clear outlier. A woman giving birth in the US faces roughly 1-in-7,933 odds of dying from a pregnancy-related cause in a high-income country context, but the US pulls that average down considerably.
The Rate Over Time
The trend line is complicated by a measurement change. Starting in 2003, US states began adding a pregnancy checkbox to death certificates, which improved identification of pregnancy-related deaths but also inflated the reported numbers. A 2025 analysis in JAMA Pediatrics estimated that this checkbox accounted for about 66% of the apparent increase in maternal mortality between 2000 and 2019. In other words, a significant portion of what looked like a worsening crisis was partly better counting.
Even after adjusting for that change, though, the numbers are not reassuring. Adjusted rates held relatively steady between about 7 and 10 deaths per 100,000 from 2000 through the late 2010s, then spiked sharply during the pandemic, peaking at nearly 19 per 100,000 in 2021. The rate of 32.9 deaths per 100,000 recorded in 2021 (before adjustment) was the highest in decades. By 2022, the rate dropped back to about 22, and it has continued declining to 17.9 in 2024. That improvement is real, but the US still hasn’t returned to pre-pandemic levels by most measures, and the rate remains far above other wealthy nations.
What Women Are Dying From
Cardiovascular conditions are the single largest category, responsible for more than a third of pregnancy-related deaths. This includes heart muscle disease (cardiomyopathy), heart attacks, and strokes. These conditions can develop during pregnancy or worsen because of the added strain pregnancy places on the heart and blood vessels.
Severe bleeding (hemorrhage) accounts for about 11.5% of deaths and is considered one of the most preventable causes. Infection, blood clots, and high blood pressure disorders round out the leading medical causes. A growing concern is deaths from suicide, accidental overdose, and violence, which increasingly appear in maternal mortality data and highlight the role mental health and substance use play in pregnancy outcomes.
Timing matters, too. About half of postpartum maternal deaths occur within the first 24 hours after birth, with bleeding and blood clots concentrated in that window. In high-income countries like the US, however, a larger share of deaths (about 38%) happen between 8 and 42 days after delivery, often from infections and cardiovascular conditions that develop or go unrecognized after the mother has left the hospital.
Stark Disparities by Race
The national average obscures enormous gaps between racial groups. In 2024, Black women died at a rate of 44.8 per 100,000 live births. That is more than three times the rate for white women (14.2) and nearly four times the rate for Hispanic women (12.1). Asian women fell in between at 18.1. These gaps persist even after controlling for income and education, pointing to systemic differences in how Black women are treated within the healthcare system, including well-documented patterns of symptoms being dismissed or undertreated.
To put the Black maternal mortality rate in perspective: 44.8 per 100,000 is a figure more typical of upper-middle-income countries than of a nation that spends more on healthcare per person than any other in the world.
Wide Gaps Between States
Geography within the US creates its own version of inequality. Using five-year estimates from 2019 to 2023, the safest state for childbirth is California, with a maternal mortality rate of 10.1 per 100,000 live births, a figure that would be roughly on par with the high-income country average. Minnesota (14.1) and Massachusetts (14.4) follow close behind.
At the other end, Tennessee has the highest rate at 42.1, followed by Louisiana (40.7), Mississippi (39.7), Wyoming (35.5), and Arkansas (35.3). The gap between California and Tennessee is fourfold. States with higher rates tend to have fewer maternity care providers, higher rates of uninsurance, more rural hospital closures, and less robust Medicaid coverage for postpartum care.
Why the US Lags Behind
Several structural factors separate the US from countries with better outcomes. The most fundamental is insurance coverage. The US is the only OECD country that does not provide universal health coverage, leaving about 8 million women of reproductive age uninsured. Even women who do have insurance, including Medicaid, often face coverage gaps. Some policies limit the number of postpartum visits covered, and bundled payment models can discourage providers from offering additional follow-up care.
Postpartum care itself is structured differently in most other wealthy countries. In the UK, the Netherlands, and Scandinavian nations, home visits by midwives or nurses in the days and weeks after birth are standard. These visits catch warning signs early, particularly the cardiovascular and infection-related complications that tend to kill women in the second through sixth week after delivery. In the US, the standard postpartum visit happens at six weeks, leaving a long window where problems can go undetected.
Paid parental leave is another factor. The US is the only one of the 38 OECD countries that does not guarantee paid maternity leave. The Family and Medical Leave Act provides up to 12 weeks of unpaid leave, but its eligibility requirements are restrictive enough that only about 59% of working mothers qualify. Without paid leave, many women return to work quickly, skip follow-up appointments, and face physical and mental health consequences that compound risk.
Countries with universal coverage, routine home visits, and paid leave create an unbroken chain of care from pregnancy through the postpartum period. The US system, by contrast, has gaps at nearly every transition point: gaps in who is insured, gaps in follow-up after discharge, and gaps in support for the social and economic stressors that affect recovery.