The World Health Organization defines maternal death as "the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes."
One of the United Nations’ Millennium Development Goals was to cut the global maternal mortality rate by 75 percent between 1990 and 2015. In fact, the overall rate—the number of maternal deaths per 100,000 live births—has been cut by 50 percent, with 157 of the 183 nations studied reporting decreases. Most of the reduction has occurred since 2000.
While the worldwide rate did not attain the U.N. goal, it has at least been falling since 2000. Not so for the United States.
In fact, the authors of a disturbing new study of vital statistics have found that the estimated maternal mortality ratio for 48 states and the District of Columbia rose from 2000 to 2014 by 26.6 percent—from 18.8/100,000 in 2000 to 23.8/100,000 in 2014. There was a single exception: California. There the rate declined.
Given that the United States has not published official statistics on maternal mortality since 2007, the study—“Recent Increases in the U.S. Maternal Mortality Rate”—is an important one. It appears in the September issue of the peer-reviewed journal, Obstetrics & Gynecology.
The authors think that the actual maternal mortality rate in the United States in 2000 may well have been higher than previously reported. Part of the reason may be that the Centers for Disease Control added a pregnancy-related question to the standard death certificate in 2003 and that may now be providing more accurate information than was available earlier. If the rate was previously higher, that would obviously reduce the amount of increase shown in the study.
Most troubling were the findings of the authors in a separate study of Texas data. They saw the same trend as in 48 other states, a rise in the maternal mortality rate from 2000. But they also detected a so-far-unexplained surge from 2010 to 2012, something that did not happen in any of the 49 other states. The number of maternal deaths in Texas took a startling leap from 72 in 2010 to 148 in 2012. The authors called this “puzzling” but noted that clarifying why this occurred will require a further study.