In 2024, 649 US women died of maternal causes, 17.9 per 100,000 live births, but that national count covers only pregnancy and 42 days and only obstetric codes, so homicide and suicide fall outside it. CDC review committees, which follow deaths to 1 year, found that 53% of pregnancy-related deaths occur after the first postpartum week and that mental health conditions are the leading cause. Homicide during pregnancy and the first 42 days is more than twice as common as any leading obstetric cause. The CDC calls 84% of pregnancy-related deaths “preventable,” but the label requires only “some chance” that a change at any level might have helped, committees applied it to 45% to 100% of deaths, and 57% of the contributing factors sit with patients and families, systems of care, and communities rather than with clinicians and hospitals. European and US rates rest on different definitions and should not be compared directly.
Scene-by-scene transcript
0 to 2 s. Title: Maternal deaths in the US. How many, when, why, and the word “preventable.”
2 to 8 s. How many women die of maternal causes (NCHS vital statistics): 658 deaths in 2018, 754 in 2019, 861 in 2020, 1,205 in 2021, 817 in 2022, 669 in 2023 and 649 in 2024. The 2024 rate was 17.9 per 100,000 live births: 44.8 for Black women, 14.2 for White women, and 62.3 for women age 40 and older.
8 to 12 s. Decades of “rising” rates were partly a counting change. A pregnancy checkbox was added to the US death certificate in 2003 and adopted by the states in a staggered way. Recoded without the checkbox, crude rates did not change significantly from 2002 to 2018; age-adjusted, they fell 21%. NCHS changed its coding in 2018, so older series do not line up with today’s (schematic of state adoption).
12 to 18 s. Three systems, three definitions. US vital statistics (NCHS): pregnancy or within 42 days, obstetric codes only (A34, O00 to O95, O98 to O99); homicide and suicide fall outside these codes. CDC maternal mortality review committees: pregnancy or within 1 year, deaths caused or aggravated by pregnancy, including suicide and overdose linked to mental health conditions. Eight European enhanced surveillance systems: the WHO 42-day definition, 2.7 (Norway) to 10.9 (Slovakia) per 100,000; suicide a leading cause in every country; only France and the UK review deaths to 1 year. The US figure of 17.9 is not directly comparable with European figures.
18 to 22 s. Causes of pregnancy-related death, 1,018 deaths in 36 states, 2017 to 2019: mental health conditions 22.7%, hemorrhage 13.7%, cardiac and coronary conditions 12.8%, infection 9.2%, thrombotic embolism 8.7%, cardiomyopathy 8.5%, hypertensive disorders 6.5%. Mental health conditions include suicide and overdose linked to substance use disorder; suicide alone accounted for 8.4%.
22 to 28 s. Timing: 21.6% during pregnancy, 13.2% on the day of delivery, 12.0% on days 1 to 6, 23.3% on days 7 to 42 and 30.0% on days 43 to 365. Delivery and the first week account for 25%; day 7 to 1 year accounts for 53%.
28 to 34 s. Murder and suicide after pregnancy. Homicide: 3.62 per 100,000 live births among women pregnant or within 1 year, 16% higher than among women not pregnant or postpartum. In pregnancy and the first 42 days, homicide was more than twice as common as any leading obstetric cause. Of 11,782 pregnancy-associated deaths in 2010 to 2019, drugs caused 11.4%, suicide 5.4% and homicide 5.4%: together 22.2%. The NCHS count stops at 42 days.
34 to 40 s. What “preventable” means to the CDC. Review committees called 84% of pregnancy-related deaths preventable. The test is whether there was at least some chance that one or more reasonable changes, at any level, might have averted the death. “Some chance” and “good chance” both count as preventable; only “no chance” does not. Across 42 state and city committees, 45% to 100% of pregnancy-related deaths got the label.
40 to 46 s. Where the contributing factors sit: 3,345 factors in 739 deaths in 14 states. Patient and family 34.2%, systems of care 18.2%, community 5.0%: 57% of all factors lie outside the obstetrician and the hospital. Clinicians 32.2% and facilities 11.5%: 44%. The patient-family share ranged from 6% to 56% between states.
46 to 56 s. Take-home: the 2024 count of 649 maternal deaths covers only 42 days and obstetric codes; homicide and suicide sit outside it. 53% of pregnancy-related deaths come after the first postpartum week. “Preventable” means some chance, not a failure of care; committees applied it to 45% to 100% of deaths. Most contributing factors lie outside the obstetrician and the hospital. Name the level and the chance. Then assign the responsibility.
Publications used in this film
Hoyert DL. Maternal mortality rates in the United States, 2024. NCHS Health E-Stats. 2026 Mar;(113):1-7. doi:10.15620/cdc/174651 National vital statistics649 deaths, 17.9 per 100,000 live births; table 2018 to 2024. Pregnancy or within 42 days; ICD-10 A34, O00 to O95, O98 to O99.
Hoyert DL, Miniño AM. Maternal mortality in the United States: changes in coding, publication, and data release, 2018. Natl Vital Stat Rep. 2020;69(2):1-18. Methods reportThe 2018 coding change and the pregnancy checkbox.
Joseph KS, Boutin A, Lisonkova S, Muraca GM, Razaz N, John S, et al. Maternal mortality in the United States: recent trends, current status, and future considerations. Obstet Gynecol. 2021;137(5):763-71. doi:10.1097/AOG.0000000000004361 Commentary on NCHS analysesReported rises were largely a surveillance artifact; crude rates unchanged 2002 to 2018 without the checkbox; age-adjusted 21% decline.
Centers for Disease Control and Prevention. Pregnancy-related deaths: data from maternal mortality review committees in 36 U.S. states, 2017-2019 [Internet]. Atlanta (GA): CDC; 2022 [updated 2024 May 28; cited 2026 Sep 29]. Available from: https://archive.cdc.gov/www_cdc_gov/maternal-mortality/php/data-research/mmrc-2017-2019.html Committee review, 1,018 deathsCauses, timing, suicide 8.4%, 84% preventable, and the definition of preventability.
Diguisto C, Saucedo M, Kallianidis A, Bloemenkamp K, Bødker B, Buoncristiano M, et al. Maternal mortality in eight European countries with enhanced surveillance systems: descriptive population based study. BMJ. 2022;379:e070621. doi:10.1136/bmj-2022-070621 Population based, 8 countries42-day ratios 2.7 to 10.9 per 100,000; suicide a leading cause in each country; only France and the UK study late deaths.
Wallace M, Gillispie-Bell V, Cruz K, Davis K, Vilda D. Homicide during pregnancy and the postpartum period in the United States, 2018-2019. Obstet Gynecol. 2021;138(5):762-9. doi:10.1097/AOG.0000000000004567 Death certificate analysis3.62 homicides per 100,000 live births; 16% above nonpregnant women. Erratum: Obstet Gynecol. 2022;139(2):347.
Margerison CE, Roberts MH, Gemmill A, Goldman-Mellor S. Pregnancy-associated deaths due to drugs, suicide, and homicide in the United States, 2010-2019. Obstet Gynecol. 2022;139(2):172-80. doi:10.1097/AOG.0000000000004649 Death certificate analysis, 33 states plus DCDrugs 11.4%, suicide 5.4%, homicide 5.4% of 11,782 pregnancy-associated deaths.
Qian J, Wolfson C, Kramer B, Creanga AA. Insights from preventability assessments across 42 state and city maternal mortality reviews in the United States. Am J Obstet Gynecol. 2025;232(4):394.e1-394.e10. doi:10.1016/j.ajog.2024.08.030 Secondary analysis, 42 review committees45% to 100% of pregnancy-related deaths deemed preventable; contributing factors by level. Shown in the film as clinician-level factors.
Version 1.0. Published 29 September 2026. Last reviewed 29 September 2026. Graphics labeled schematic are teaching illustrations; all other numbers come from the publications listed.