United States maternal death statistics that have been used for over a decade have finally been updated. The CDC released 2018 national and state maternal death estimates last week. The numbers have increased dramatically and still remain the worst of any developed country in the world.

Currently, the maternal mortality rate (MMR) is 17.4 deaths per 100,000 live births. In 2007, the MMR was 12.7 deaths per 100,000 live births. The CDC says the MMR increase largely comes from the new data and collection requirements now on standard death certificates. Starting in 2003, a checkbox requirement was placed on the U.S. Standard Certificate of Death in order to accurately record maternal deaths. The checkboxes are:

• Not pregnant within past year
• Pregnant at time of death
• Not pregnant, but pregnant 43 days to 1 year before death
• Not pregnant, but pregnant within 42 days of death
• Unknown if pregnant within the past year

The last state to adopt the checkbox on death certificates, West Virginia, finally added it in mid-year 2017 prompting this new MMR data. The CDC also admits that there have been some misclassification of maternal deaths due to checkbox errors and are working with states to make the data more reliable and accurate.

In 2018, 658 women died from maternal causes. As has been the case for decades, black women die in increased numbers than all other ethnic groups: non-Hispanic black (37.1 per 100,000 live births), non-Hispanic white (14.7), and Hispanic (11.8) women.

Additionally, older women die in increased numbers. In fact, women aged 40 and over (81.9 per 100,000 live births) is nearly 8 times that for women under age 25 (10.6).

Some researchers charge that the maternal death numbers are increasing too quickly. As aforementioned, the CDC recognizes that data inaccuracies may happen due to checkbox errors. The main objective, however, is that the methods are trending in the right direction in that states are starting to adopt new classifications to accurately record how women are dying. It took 14 years for all states to adopt the new checkboxes on the U.S. Standard Certificate of Death and 13 years for an updated maternal mortality rate statistic. Now, that more emphasis is being placed on maternal health and mortality in the United States, the CDC’s National Center for Health Statistics is working quicker to provide more accurate data.

Image created by Uzuri Art.