Access matters, but it is not the whole story.
Regions with fewer birth centers often show higher risk, but the pattern is not perfectly linear, which suggests geography, policy, demographics, and facility quality also matter.
The Problem
Most U.S. maternal deaths are preventable.
The United States has the highest maternal mortality rate of any wealthy nation — and unlike its peers, that rate is getting worse. This project investigates why, where intervention would matter most, and what policy exports from top-performing countries could look like in practice.
84%
of U.S. maternal deaths are classified as preventable.
NEJM · NIH / PubMed
4.5×
Black women die at 4.5× the rate of Asian women — the largest racial gap in any high-income nation.
CDC NCHS · 2021
+56%
increase in maternal mortality in states with abortion bans following the Dobbs decision.
GEPI · Kaiser Family Foundation
−38%
the opposite direction peer developed nations moved over the same period.
OECD · World Bank
If the U.S. matched Norway's maternal mortality rate, roughly 9 out of every 10 American mothers who die each year would live.
Back-of-envelope · OECD 2020 · CDC 2023
01 · Purpose
Why this project exists.
Maternal mortality is one of the only headline health indicators where the U.S. has gone backwards while every comparable country has improved. Our goal is to make the scale of that reversal unignorable — and to trace it to specific, fixable causes.
We're building a data-first investigation that (a) examines regional and racial disparities in maternal death, (b) identifies the leading causes and how they've shifted, (c) benchmarks U.S. performance against top-performing countries to surface transferable policy, and (d) investigates why U.S. rates continue to rise while peer countries' fall.
02 · Assumptions
What we're taking as given.
The data sources we rely on — CDC NCHS, the World Bank, OECD, and peer-reviewed work out of NEJM and NIH — each involve methodology choices. These are the priors we're operating under:
Definition
We use the WHO definition of a maternal death: a death during pregnancy or within 42 days of its end from pregnancy-related causes.
Preventability
We accept the CDC's Maternal Mortality Review Committees' standard that a death is "preventable" if reasonable changes by patient, provider, facility, system, or community could have averted it.
Comparability
Cross-country comparisons use OECD harmonized rates. U.S. state and county-level numbers may be noisier and we flag small-n rows.
Scope
We focus on deaths within the 42-day window. Extending to 1 year (late maternal deaths) roughly doubles the U.S. figure, but that's for a later build.
