1. Simpson, Kathleen Rice PhD, RNC, CNS-BC, FAAN

Article Content

The Centers for Disease Control and Prevention (CDC, 2019) published data on maternal mortality in the United States, (Petersen et al., 2019). Key findings are presented. Deaths caused by "a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy are classified as pregnancy-related" (Petersen et al., 2019, p. 2). These include deaths during pregnancy and up to 1 year after birth.


Causes of Maternal Death

The CDC uses 10 mutually exclusive categories for cause of death: hemorrhage; infection; amniotic fluid embolism; thrombotic pulmonary or other embolism (i.e., air, septic, or fat); hypertensive disorders of pregnancy (i.e., preeclampsia or eclampsia); anesthesia complications; cerebrovascular accidents; cardiomyopathy; other cardiovascular conditions (e.g., congenital heart disease, ischemic heart disease, cardiac valvular disease, hypertensive heart disease, and congestive heart failure); and other noncardiovascular medical conditions (e.g., endocrine, hematologic, immunologic, and renal). Deaths attributable to suicide, drug overdose, homicide, and unintentional injury are excluded. Cardiovascular conditions, infection, and hemorrhage are the leading causes of death.


Timing of Maternal Deaths

Timing was unknown for 12.3% of deaths; however of those for which timing was known, 31.3% occurred during pregnancy, 16.9% on the day of birth, 18.6% on days 1 to 6 postpartum, 21.4% on days 7 to 42 postpartum, and 11.7% on days 43 to 365 postpartum.


Number of Maternal Deaths

About 700 women die each year in the United States from pregnancy-related complications. During 2011 to 2015, 3,410 pregnancy-related deaths occurred; overall pregnancy-related maternal mortality ratio (PRMR) was 17.2 pregnancy-related deaths per 100,000 live births.


Racial and Ethnic Disparities in Maternal Deaths

There are major racial and ethnic disparities in pregnancy-related mortality. The highest PRMRs were in women who were Black (42.8) and American Indian/Alaska Native (32.5); these PRMRs were 3.3 and 2.5 times as high, respectively, as those in White women (13.0). These differences are likely due to racism that many Black women and non-White women face when seeking healthcare.


Preventability of Maternal Deaths

About 60% of pregnancy-related deaths were identified as preventable. These did not differ significantly by race/ethnicity or timing of death.


What Can Nurses Do?

Nurses care for women during the entire childbearing process. Thus, nurses are ideal members of state maternal mortality review committees and leaders of hospital, health system, statewide, and national perinatal quality improvement projects. Take an active leadership role in these efforts to reduce maternal mortality in the United States.




Petersen E. E., Davis N. L., Goodman D., Cox S., Mayes N., Johnston E., ..., Barfield W. (2019). Vital signs: Pregnancy-related deaths, United States, 2011-2015, and strategies for prevention, 13 states, 2013-2017. Morbidity and Mortality Weekly Report, 68(18), 423-429. icon [Context Link]