Research finds maternal death rate increasing in U.S.

The number of women who die during or soon after pregnancy is on the rise in the United States, while on the decline internationally, according to new research from the University of Maryland Population Research Center (MPRC).

The U.S. maternal mortality rate rose by nearly 27 percent between 2000 and 2014, according to the study. For every 100,000 live births, nearly 24 women died during, or within 42 days after pregnancy in 2014. That was up from nearly 19 per 100,000 in 2000.

"It's important to note that maternal death is still a rare event, but it is of great concern that the rate is increasing, rather than improving," said the study's lead author Dr. Marian MacDorman, an MPRC research professor. "Maternal mortality is an important indicator of the overall quality of health care both nationally and internationally."

MacDorman noted that some of the national increase in maternal deaths has to do with better reporting. In 2003, U.S. states began revising their death certificates to include specific questions about pregnancy. However, the 27% increase was found after taking into account these changes in reporting, MacDorman said. What makes the U.S. statistics even more discouraging is that the numbers are trending in the opposite direction around the world: Study authors say the United States would rank 30th on a list of 31 countries reporting data on maternal mortality to the Organization for Economic Cooperation and Development—beating out only Mexico.

"Clearly, the U.S. maternal mortality rate is moving in the wrong direction," MacDorman said. "There is a need to redouble efforts to prevent maternal deaths and improve maternity care for the 4 million U.S. women giving birth each year."

The UMD research team did discover one bright spot amid a glum national picture. California showed a marked decline in maternal mortality from 2003 to 2014, following concerted efforts in the state to address the issue, including a statewide pregnancy-associated mortality review and initiatives focused on preventing some of the most common contributors to maternal death; obstetric hemorrhage and preeclampsia.

"These efforts appear to have reduced maternal mortality in California and could serve as a model for other states," MacDorman said.