Why Childbirth Is Still Dangerous in America—and What We Can Do About It

Bringing a child into the world is a natural process, but pregnancy and childbirth are also medical conditions that carry significant health risks.

Rates of maternal mortality (death during pregnancy or within one year postpartum) and maternal morbidity (complications that occur during or after pregnancy) continue to rise in the United States. According to the Centers for Disease Control, from 2018 to 2022 the U.S. maternal mortality rate increased from 17.4 deaths per 100,000 live births to 33.6—a concerning 93 percent increase.

Though the current rate is estimated to have decreased since 2022, the U.S rate is still significantly higher than other countries like Germany and Australia, where rates are less than 4 deaths per 100,000 live births annually.

When nursing influencer Hailey Okula died after giving birth to her child in April 2025, her social media followers were shocked, spurring vital conversations about childbirth risks. The public often underestimates these real dangers because pregnancy complications aren't openly discussed.

“We do a disservice to our patients by not talking about pregnancy complications,” said Maternal Fetal Medicine provider Dr. Ponnila Marinescu. "Pregnancy can involve significant risks for the individual carrying the child, and many aspects may deviate from what is anticipated. "

Why Maternal Deaths Are High in the U.S.

Multiple interconnected factors contribute to America’s maternal mortality rates.

Disparities in Healthcare

According to the American College of Obstetricians and Gynecologists (ACOG), non-Hispanic Black individuals have a rate of pregnancy-related deaths that is 2.6 times higher than white individuals, while Indigenous individuals experience rates 2.4 times higher.

These disparities stem from:

• Limited access to quality care
• Geographic barriers to specialized maternal care
• Implicit bias affecting clinical decision-making
• Outdated healthcare structures

To fully address these issues, providers need extensive specialized training, along with a major reconstruction of healthcare systems.

Abortion Restrictions

Restrictive abortion laws are increasingly affecting comprehensive pregnancy care. When treatment options are limited, risks multiply—particularly for patients with:

• Complex medical and psycho-social conditions
• Life-threatening pregnancy complications
• Fetal diagnoses incompatible with life
  
  

According to the Turnaway Study conducted by Dr. Diana Greene Foster, these consequences may include:

• Poorer long-term physical health (e.g., worsening renal disease, diabetes, hypertension)
• Economic hardship
• Increased risk for domestic violence
  
  

An additional effect may be increased risk for complications during the pregnancy (e.g., preeclampsia, peripartum cardiomyopathy).

“The attempt to politicize this subject by painting it as black and white ultimately covers up its complexities and nuances,” said Dr. Marinescu.

Delayed Recognition of Warning Signs

Many patients and even some providers lack education about serious pregnancy complications. Recognition of warning signs and rapid treatment can be lifesaving.

Many people in the United States have a perception that a successful, healthy pregnancy is a right and not a privilege. When complications arise, families are unprepared for the reality that pregnancy can be dangerous.

What Are the Most Common Causes of Maternal Death?

The leading causes of maternal mortality are:

• Cardiovascular conditions—including arrhythmias, heart disease, and cardiomyopathy

• Infection

• Postpartum hemorrhage—severe bleeding after delivery

• Pulmonary embolism—blood clots in lungs

• Hypertensive disorders—including preeclampsia and eclampsia

How Can We Prevent Maternal Deaths?

Education and awareness are key to prevention, which is especially difficult with this topic.

“My ask is that we engage in conversation as a community. Pregnancy risk has become this thing nobody wants to recognize—but this highlights the critical need for a better understanding of morbidity and mortality and for efforts to reduce the rates of adverse outcomes,” said Dr. Marinescu.

Talking about the risks associated with pregnancy and childbirth is important—not just for pregnant individuals and providers, but for the public.

Is Home Birth Safe?

While respecting autonomy, Dr. Marinescu does encourage her patients who are interested in experiencing an out-of-hospital birth to consider the benefits of delivering in the hospital. Immediate access to medical care can make a huge difference in a critical situation. This is especially important for individuals with greater risk of complications.

If choosing home birth, essential safety measures include:

• Consultation with an OB-GYN or Maternal-Fetal Medicine (MFM) specialist
• Clear hospital backup plans and transfer protocols
• Qualified certified nurse-midwife or certified midwife attendance
• Pre-established emergency transport arrangements
• Hospital bag prepared with medical records and emergency contacts

UR Medicine’s Commitment to Maternal Health

UR Medicine is implementing quality improvement initiatives based on data-driven quality indicators and outcome tracking. Our providers are committed to responsive healthcare and provide honest counseling to all patients.

By acknowledging pregnancy's inherent risks and working actively to address them, UR Medicine is making strides in protecting the health of parents and families.

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