What are examples and causes of maternal morbidity and mortality?

Maternal morbidity includes a range of different health conditions. Some of them start during pregnancy and last only a short time, while others do not develop until years after a pregnancy and continue throughout the woman’s life.

Maternal mortality usually results from a pregnancy, delivery, or postpartum complication; a chain of medical events started by the pregnancy or delivery; the worsening of an unrelated condition because of the pregnancy or delivery; or other factors.1

Maternal Morbidity

Maternal health problems related to pregnancy and giving birth can occur during pregnancy, during delivery, and after a pregnancy ends. Some common examples of maternal morbidity include the following2:

  • Cardiovascular problems, such as heart disease and blood vessel problems
  • Diabetes
  • High blood pressure
  • Infections, especially from cesarean section
  • Blood clots
  • Bleeding (sometimes called hemorrhage)
  • Anemia (low iron in the blood)
  • Nausea and vomiting (sometimes called morning sickness) and hyperemesis gravidarum (severe morning sickness)
  • Depression and anxiety

The Centers for Disease Control and Prevention (CDC) uses International Classification of Disease codes and whether a woman is hospitalized to group examples of severe maternal morbidity (SMM). Some SMM examples include heart attack, heart failure, eclampsia, sepsis/blood infection, and hysterectomy.3 If a woman needs breathing assistance, such as a ventilator, or needs a blood transfusion, it is also considered SMM.

Maternal Mortality

According to the World Health Organization (WHO), the following cause the majority of maternal deaths around the world4:

  • Severe bleeding (sometimes called hemorrhage)
  • Infections
  • Blood pressure disorders of pregnancy, including preeclampsia and eclampsia
  • Complications of labor and delivery
  • Unsafe abortion

Infections and chronic medical conditions, such as diabetes, are also causes of or associated with maternal deaths worldwide.

In the United States, CDC tracks pregnancy-related deaths, including deaths that WHO calls “maternal mortality.” The leading causes of pregnancy-related death in the United States, according to CDC, are slightly different than maternal mortality causes around the world.

In the United States, the main causes of pregnancy-related deaths include the following5:

  • Severe bleeding (sometimes called hemorrhage)
  • Infections and sepsis
  • Cardiovascular conditions, such as:
    • Blockages (sometimes called embolisms) in arteries and veins
    • Stroke (also called cerebrovascular accidents)
    • Blood pressure disorders of pregnancy, including preeclampsia and eclampsia
    • Heart muscle problems (called cardiomyopathy)
    • Heart disease
  • Problems with anesthesia
  • Amniotic fluid embolism
  • Non-cardiovascular conditions, such as diabetes and breathing problems

For more information on national trends and causes of pregnancy-related death, visit CDC: Pregnancy Mortality Surveillance System.

CDC also reports on pregnancy-associated deaths, from causes unrelated to pregnancy. Common causes of pregnancy-associated deaths include trauma (including motor vehicle accidents), homicide, suicide, and drug overdoses.6,7,8

NICHD provides information on many topics relevant to maternal morbidity and mortality, including the following:

Find more resources about maternal morbidity and mortality.

Citations

    1. Centers for Disease Control and Prevention (CDC). (2019). Pregnancy-related deaths. Retrieved January 15, 2020, from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-relatedmortality.htm.
    2. CDC. (2018). Pregnancy complications. Retrieved March 3, 2020, from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-complications.html.
    3. CDC. (2019). How does CDC identify severe maternal morbidity? Retrieved March 3, 2020, from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/smm/severe-morbidity-ICD.htm.
    4. World Health Organization. (2019). Maternal mortality. Retrieved January 15, 2020, from https://www.who.int/en/news-room/fact-sheets/detail/maternal-mortality external link.
    5. CDC. (2019). Pregnancy mortality surveillance system. Retrieved January 15, 2020, from https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-mortality-surveillance-system.htm.
    6. Mangla, K., Hoffman, M. C., Trumpff, C., O’Grady, S., & Monk, C. (2019). Maternal self-harm deaths: An unrecognized and preventable outcome. American Journal of Obstetrics and Gynecology, 221(4), 295–303. Retrieved April 29, 2020, from https://doi.org/10.1016/j.ajog.2019.02.056 external link.
    7. Sakamoto, J., Michels, C., Eisfelder, B., & Joshi, N. (2019). Trauma in pregnancy. Emergency Medical Clinics of North America, 37(2), 317–338. Retrieved April 29, 2020, from https://doi.org/10.1016/j.emc.2019.01.009 external link.
    8. Metz, T. D., Rovner, P., Hoffman, M. C., Allshouse, A. A., Beckwith, K. M., & Binswanger, I. A. (2016). Maternal deaths from suicide and overdose in Colorado, 2004–2012. Obstetrics and Gynecology, 128(6), 1233–1240. Retrieved April 29, 2020, from https://doi.org/10.1097/AOG.0000000000001695 external link.
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