Maternal mortality is one of the most concerning women's health metrics — and one of the most slowly addressed. Rates are rising in several developed countries that have first-world healthcare in other respects. The reasons are complex; the consequences are stark.
The data that should be widely known
US maternal mortality rate: 32.9 per 100,000 live births (2023). Rising for the past decade. Highest in the developed world by a significant margin.
UK rate: 13.4 per 100,000 (2020-2022). Significantly lower than US but rising; up from 8.8 in 2017-2019. Three-year average rising.
Most European countries: 2-7 per 100,000. Many maintain levels US has never reached.
Where the racial disparity is starkest
US: Black women die in childbirth at 3-4x the rate of white women. The gap is largest among college-educated Black women vs. less-educated white women — suggesting healthcare system failure rather than socioeconomic explanation.
UK: Black women 3.7x more likely to die in pregnancy than white women (MBRRACE-UK 2024). Asian women 1.8x. The gaps have not closed despite repeated investigation and policy attention.
What's driving the trend
Increasing maternal age (older mothers face slightly higher risk). Increasing rates of co-morbidities (obesity, diabetes, hypertension before pregnancy). Healthcare system failures particularly affecting marginalised groups — slower response to warning signs, dismissal of patient concerns, particularly affecting Black and ethnic minority women. Mental health-related deaths (suicide, accidents) rising as proportion of overall maternal mortality.
Where interventions show evidence of working
Maternal early warning systems (EWS) — standardised escalation criteria that reduce 'subjective' decision-making about whether to act on warning signs. Birthing-person-led care models with consistent caregiver across pregnancy and birth. Postnatal care extending beyond 6 weeks (mental health screening through first year postpartum). Targeted programs for Black and ethnic minority pregnancies in higher-risk areas.
Where the next decade should focus
Addressing race-specific gaps. Maternal mental health as part of routine postnatal care. Investing in midwifery-led care models in low-risk pregnancies. Better data collection and faster response to emerging trends.
Maternal mortality is one of the most concerning women's health trends in developed economies. Most women don't realise the numbers are moving in the wrong direction; the racial dimensions are even less widely known.