U.S. lags peers on maternal deaths
A Commonwealth Fund analysis highlighted by AJMC finds the United States has higher maternal and child mortality than most other high-income countries, pointing to underinvestment and uneven access across the care continuum. The report argues the problem isn’t just labor-and-delivery management but gaps in access, postpartum support, and system-level factors that shape outcomes. (ajmc.com)
The United States recorded 17.9 maternal deaths for every 100,000 live births in 2024, and that was still far above the average for peer countries tracked by the Organisation for Economic Co-operation and Development. The new Commonwealth Fund comparison says the gap is not a one-year blip but a long-running pattern. (cdc.gov) (commonwealthfund.org) A maternal death means a woman dies during pregnancy or within 42 days after it ends from causes tied to the pregnancy or its management. By that measure, the United States has stayed well above countries like Sweden, Germany, the Netherlands, Japan, and the United Kingdom. (cdc.gov) (commonwealthfund.org) The child side looks bad too. The Commonwealth Fund found that infant and child mortality in the United States also exceeds rates in most other high-income countries, which means the weakness is not limited to the delivery room. (commonwealthfund.org) (ajmc.com) That is the core of the report: babies and mothers do not move through one medical event, they move through a chain. If prenatal visits are delayed, hospitals are far away, insurance drops after birth, or warning signs are missed in the weeks after delivery, the whole chain gets weaker. (commonwealthfund.org) (ajmc.com) One reason the United States stands out is that it spends more on health care overall than any other wealthy country but still gets worse maternal outcomes. KFF Health News and Peterson Center analyses cited by international comparisons put the 2023 U.S. maternal death rate at 18.6, versus about 5.1 across comparable countries on average. (healthsystemtracker.org) (oecd.org) The averages also hide a huge racial gap inside the country. The Centers for Disease Control and Prevention reported that Black women in the United States had a maternal mortality rate of 50.3 deaths per 100,000 live births in 2023, compared with 14.5 for White women, 12.4 for Hispanic women, and 10.7 for Asian women. (cdc.gov) Geography changes the odds too. The Commonwealth Fund found Louisiana had the highest maternal mortality rate among U.S. states in 2023 at 41.9 deaths per 100,000 live births, and Mississippi had the highest child mortality rate. (commonwealthfund.org) (ajmc.com) Postpartum care is one of the biggest weak spots. Many dangerous complications, including bleeding, infection, high blood pressure, blood clots, and heart problems, can hit after a mother leaves the hospital, and the Commonwealth Fund says other countries do more to guarantee follow-up support in that period. (commonwealthfund.org 1) (commonwealthfund.org 2) The policy fight now reaches past hospital staffing and emergency obstetrics. The AJMC coverage notes warnings that Medicaid cuts and the post-Roe abortion landscape could make access less consistent before, during, and after pregnancy, especially in states that already have the worst outcomes. (ajmc.com) (commonwealthfund.org) So the latest report is not saying the United States needs one better delivery ward. It is saying the country built a pregnancy system with breaks at every stage, and those breaks show up in two hard numbers: more mothers dying and more children dying than in most other rich nations. (commonwealthfund.org) (ajmc.com)
