Pregnancy-Related Deaths in the US, 2018-2022 JAMA Network Open, 2025
2,679 American mothers died preventable deaths in four years—not from lack of medical knowledge, but from a three-fold gap between the best and worst states that proves maternal mortality is a policy choice, not an inevitability.
Researchers looked at all pregnancy-related deaths in the US from 2018 to 2022—over 6,000 women who died during pregnancy or within one year of giving birth. The death rate jumped 28% during this time, from about 25 to 33 deaths per 100,000 births. The differences between states were shocking: Alabama had the highest rate (60 deaths per 100,000), while California had the lowest (19 per 100,000). If every state matched California’s rate, nearly 2,700 women would still be alive. The racial gaps were even worse. American Indian and Alaska Native women died at nearly four times the rate of white women. Black women died at nearly three times the rate. Heart disease was the leading killer overall, but mental health problems, drug overdoses, and cancer were major causes of deaths occurring weeks to months after delivery.
What It Means
This study proves what we already suspected: American women are dying at rates that would cause outrage in any other wealthy country, and most of these deaths are preventable. The three-fold difference between the best and worst states tells us this isn’t inevitable—it’s a policy choice. States that invest in maternal health have lower death rates. States that don’t, kill more mothers. The racial disparities are a national shame. A Black woman in Alabama faces risks that would be unthinkable in Western Europe. The study also highlights a hidden crisis: deaths happening weeks or months after delivery from heart disease, overdoses, and suicide. These women fall through the cracks between obstetric care and primary care, with no one watching over them during the most dangerous period.
My Take
While we spend endless political energy fighting about abortion, women are dying from causes we know how to prevent. Heart disease. Hypertension. Hemorrhage. Overdoses. Depression. And from not being able to save women’s lives in abortion-restricted states because the fetus takes precedent.
These aren’t mysteries—they’re failures of a system that abandons women the moment they leave the hospital. California shows it’s possible to do better. They invested in quality improvement, hemorrhage protocols, and maternal safety bundles. Their death rate dropped. Meanwhile, states like Alabama and Mississippi—which claim to be “pro-life”—lead the nation in killing mothers. The 2,700 preventable deaths over five years represent daughters, sisters, mothers of young children. Each one is a policy failure, not a medical inevitability. We have the knowledge to fix this. What we lack is the political will to prioritize keeping pregnant women alive over scoring points in the culture wars.