Maternal Mortality: The U.S. Remains One of the Most Dangerous High-Income Countries for Childbirth, According to a New Report

The March of Dimes, an organization advocating for the health of birthing people and babies, just released their latest report on infant and maternal health. The report reinforces what is, unfortunately, a clear fact by now: U.S. rates of maternal mortality, non-fatal pregnancy and childbirth complications, and poor infant outcomes are all terribly, unacceptably high.

“Today, the U.S. remains among the most dangerous of developed nations for childbirth, particularly for communities of color,” says the report, which March of Dimes released on November 15. To compile the report, the organization analyzed U.S. maternal and infant health outcomes based on metrics like infant mortality, Cesareans in low-risk pregnancies, access to prenatal care, and social drivers of health. 

Pregnancy-related deaths have doubled in the last 30 years, according to the report, with more than 700 women dying of these causes each year in the U.S. The nation’s rates of severe maternal morbidity, which the Centers for Disease Control and Prevention (CDC) defines as ”unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to a woman’s health,” are even higher. Some 60,000 women face serious health challenges from giving birth every year.

Much of the report focused specifically on pre-term birth as a measurement of how the nation handles maternal and infant health. For the country as a whole, preterm birth declined slightly from 10.2% in 2019 to 10.1% in 2020. Even at such a small reduction, it’s the first time the rate has gone down at all in six years. But a rate that high still resulted in the March of Dimes giving the U.S. a grade of C- for preterm birth, the same grade the country received in 2019. 

When it comes to individual states, six received an F for preterm birth in 2020: Arkansas, Louisiana, Mississippi, Alabama, South Carolina, and West Virginia. (So did Puerto Rico.) At 14.2%, Mississippi had the highest average preterm birth rate. Unsurprisingly, racial disparity for preterm birth was stark: Black women in Mississippi had a 44% higher rate of preterm birth (17.1%) than all other women. Mississippi also had an infant mortality rate of 9.1 deaths per 1,000 live births in 2019 (the last year for which data was available). 

The highest grade for preterm birth went to Vermont, which managed the country’s only “A” rating in 2020. Preterm births were at 7.6% and infant mortality was 2.8 deaths in every 1,000 live births. But it’s worth noting Vermont has an overwhelmingly white population—in 2019, 94.2% of the state’s residents were white, according to the U.S. Census. Comparatively, in 2019, 37.8% of Mississippi’s population was Black, per the U.S. Census.

The March of Dimes further dove into racial disparities in maternal and infant mortality across the country, with disheartening findings. “Black, American Indian and Alaska Native women and their babies consistently have worse health outcomes than their white peers,” the report says. Specifically, Black and Indigenous birthing people are 60% more likely to experience preterm birth compared to White women, the report says, and their babies are twice as likely to die before their first birthday than white babies.