Maternal death remains one of the most serious and devastating risks associated with pregnancy and childbirth. While most pregnancies end safely, some women experience life-threatening complications during pregnancy, labor, delivery, or in the weeks and months after birth. Understanding these risks, recognizing warning signs, and knowing when to seek help can make a life-saving difference.

This page provides families with clear, medically accurate information about maternal death and serious pregnancy-related complications. Our goal is to help you and your family understand what these conditions are, why they happen, and what can be done to reduce risk and improve outcomes.

What Is Maternal Death?

Maternal death is defined as the death of a woman during pregnancy, childbirth, or within one year after the end of pregnancy, from any cause related to or made worse by the pregnancy or its management. This does not include deaths from accidental or unrelated causes.

The timing matters. Deaths are categorized based on when they occur in relation to pregnancy. Some happen during pregnancy itself, others during labor and delivery, and many occur in the postpartum period, especially in the first six weeks after birth. However, complications can emerge or worsen even months later, which is why the medical definition extends to one year.

What Are Maternal Complications?

Maternal complications are severe, unexpected medical events that happen during pregnancy, labor, delivery, or the postpartum period. These complications have significant effects on a mother’s health, both immediately and over the long term. They can require emergency intervention, extended hospitalization, or ongoing medical treatment.

For every maternal death in the United States, approximately 70 women experience severe maternal complications. These events are often preventable with timely recognition and appropriate care.

Why This Matters

The United States has a higher maternal mortality rate than many other developed countries, and the numbers have been rising. In 2021, the maternal mortality rate reached 32.9 deaths per 100,000 live births, compared to 20.1 in 2019. While the number of deaths decreased from 817 in 2022 to 669 in 2023, this still represents hundreds of families affected by preventable tragedy.

Research consistently shows that 80 to 90 percent of pregnancy-related deaths in the U.S. are preventable with better access to care, earlier recognition of warning signs, and evidence-based medical management.

Certain groups of women face significantly higher risks. Black women and American Indian and Alaska Native women have maternal mortality rates two to three times higher than white women in New York State and New York City. In New York City specifically, Black women are six times more likely to die from pregnancy-related causes than white women. These disparities reflect systemic issues in healthcare access, quality of care, and how symptoms are recognized and responded to across different communities.

Leading Causes of Maternal Death and Complications

The causes of maternal death have shifted over time. Today, the leading causes include:

Cardiovascular Disease

Heart and blood vessel conditions are now the leading cause of pregnancy-related death. This category includes hypertensive disorders, cardiomyopathy (weakening of the heart muscle), stroke, and heart failure. Pregnancy places significant stress on the cardiovascular system, and conditions that were stable before pregnancy can become dangerous during or after birth.

Severe Bleeding

Postpartum hemorrhage, or excessive bleeding after delivery, is one of the most common life-threatening complications. It can happen suddenly and requires immediate intervention, including blood transfusions or emergency surgery such as hysterectomy.

Infection

Infections can develop during pregnancy, delivery, or after birth. Sepsis, a severe body-wide response to infection, can quickly become life-threatening. During the pandemic, COVID-19 infection contributed to over 30 percent of maternal deaths in the most recent reporting period.

Blood Clots

Venous thromboembolism refers to blood clots that form in the veins, most commonly in the legs or lungs. Pregnancy increases the risk of clotting, and pulmonary embolism (a clot in the lungs) can be fatal if not recognized and treated quickly.

Pregnancy-Induced Hypertension

Preeclampsia and eclampsia are serious conditions involving dangerously high blood pressure during pregnancy or after delivery. Eclampsia includes seizures and can lead to stroke, organ damage, or death if not managed immediately.

Mental Health Conditions

Mental health complications, including severe depression, anxiety, substance use disorder, and suicide, are a growing and often overlooked contributor to maternal mortality. The postpartum period is a particularly vulnerable time.

Amniotic Fluid Embolism

This rare but catastrophic event occurs when amniotic fluid enters the mother’s bloodstream, triggering a severe reaction that affects the heart, lungs, and blood clotting system. It is difficult to predict and requires immediate emergency response.

Chronic Conditions and Advanced Maternal Age

Pre-existing conditions such as diabetes, obesity, kidney disease, autoimmune disorders, and heart conditions increase the risk of complications during pregnancy. Women aged 40 and older have the highest maternal mortality rate at 59.8 deaths per 100,000 live births, though risk is present at all ages.

Major Complications That Require Emergency Care

Even when maternal death is prevented, serious complications can have lasting effects. Some of the most significant maternal complications include:

Severe hemorrhage requiring blood transfusion or emergency hysterectomy
Disseminated intravascular coagulation, a dangerous disorder affecting blood clotting
Sepsis and other severe infections
Acute kidney failure
Acute respiratory failure or need for mechanical ventilation
Venous thromboembolism, including deep vein thrombosis and pulmonary embolism
Heart attack or other cardiac events
Stroke or other neurologic impairment

These complications can result in extended stays in intensive care units, multiple surgeries, permanent disability, or long recovery periods that affect a mother’s ability to care for her newborn.

Recognizing Warning Signs

Knowing the urgent warning signs of maternal complications can save lives. Women and their families should seek immediate medical attention if any of the following occur during pregnancy or in the year after delivery:

Severe headache that does not go away
Dizziness or fainting
Chest pain or difficulty breathing
Heavy bleeding or soaking through more than one pad per hour
Severe abdominal or pelvic pain
Sudden swelling in the face, hands, or legs
High fever or chills
Thoughts of harming yourself or your baby
Uncontrolled nausea or vomiting
Sudden vision changes or seeing spots

Do not wait or assume symptoms will pass. Call your healthcare provider, go to the emergency room, or call 911 if you are experiencing any of these symptoms.

Prevention and Risk Reduction

Most maternal deaths and severe complications are preventable. Prevention requires action from healthcare systems, providers, and patients working together. Key strategies include:

Early and Regular Prenatal Care

Beginning prenatal care early in pregnancy and attending all scheduled appointments allows providers to monitor health, identify risk factors, and address problems before they become emergencies.

Managing Chronic Conditions

Women with diabetes, high blood pressure, obesity, heart disease, or other chronic conditions should work with their healthcare team to optimize management before and during pregnancy. This often involves a multidisciplinary care team including specialists.

Screening and Treatment for Infections

Routine screening for infections during pregnancy and prompt treatment when needed can prevent serious complications like sepsis.

High-Risk Pregnancy Management

Women identified as high-risk should receive care from maternal-fetal medicine specialists and deliver in facilities equipped to handle emergencies. This includes access to blood banks, intensive care units, and surgical capabilities.

Patient and Provider Education

Both patients and healthcare providers need to recognize warning signs and take them seriously. Women should feel empowered to speak up about symptoms, and providers must listen and respond appropriately, especially when caring for women of color and other groups at higher risk.

System-Level Improvements

Hospitals and healthcare systems can implement perinatal quality improvement programs that focus on safety protocols, equitable care, standardized emergency response procedures, and comprehensive postpartum follow-up. Programs like maternal mortality review committees analyze every case to identify missed opportunities and improve future care.

Medical Care and Intervention

When complications arise, swift and coordinated medical intervention is essential. Modern maternal care emphasizes:

Early Identification

Identifying high-risk patients before complications occur and recognizing early signs of problems allows for proactive management rather than reactive crisis response.

Multidisciplinary Care

Many complications require expertise from multiple specialties. Obstetricians work alongside cardiologists, hematologists, anesthesiologists, critical care physicians, and other specialists to provide comprehensive care.

Evidence-Based Protocols

Hospitals use standardized, research-based protocols for managing emergencies such as postpartum hemorrhage, hypertensive crisis, sepsis, and cardiac arrest. These protocols ensure that every team member knows their role and that care is delivered quickly and consistently.

Culturally Competent Care

Addressing racial and ethnic disparities in maternal outcomes requires providers and systems to deliver care that is respectful, responsive to individual needs, and aware of how bias affects treatment decisions.

Maternal Morbidity Review

Organizations like New York City’s Maternal Mortality Review Committee evaluate all cases of severe complications and deaths to understand what happened, identify preventable factors, and recommend system improvements.

Current Statistics

Understanding the scope of maternal death and complications helps put individual experiences into context and highlights the need for ongoing improvement:

In 2023, there were 669 maternal deaths in the United States, compared to 817 in 2022. While this represents a decrease, the numbers remain unacceptably high and significantly higher than in previous decades.
The maternal mortality rate in 2021 was 32.9 deaths per 100,000 live births, up from 23.8 in 2020 and 20.1 in 2019.
Black women and American Indian and Alaska Native women experience maternal mortality rates two to three times higher than white women in both New York State and New York City.
In New York City, Black women are six times more likely to die from a pregnancy-related cause than white women.
For every maternal death, approximately 70 women experience severe maternal complications requiring emergency intervention.
COVID-19 infection contributed to over 30 percent of maternal deaths in the most recent reporting period.
Maternal deaths occur most frequently in women aged 40 and older, at a rate of 59.8 per 100,000 live births, but risk exists at all ages.

These statistics represent real families who have experienced loss or serious medical crises. They also remind us that much work remains to ensure safe pregnancy and childbirth for all women.

Support for Families

Families affected by maternal death or severe complications face enormous challenges, both immediately and in the long term. Support is available and important for healing and recovery.

Hospital-Based Support

Most hospitals provide access to social workers, chaplains, and grief counselors who can offer emotional support and practical assistance. These professionals can help with everything from navigating hospital systems to planning next steps.

Review Committees and Resources

State and local maternal mortality review committees not only analyze cases to improve care but also offer resources and support to affected families. These committees exist in New York and many other states.

Community and Advocacy Organizations

Many organizations focus specifically on supporting families affected by maternal complications and working to reduce disparities in maternal health outcomes. These groups provide peer support, education, and opportunities to advocate for systemic change.

Care for Infants

When maternal complications occur, infants may also face medical challenges. Early intervention services can provide developmental support and therapies for babies affected by perinatal complications.

Finding Trusted Information

NYBirthInjury.com exists to provide families with trusted, medically accurate information about birth injuries and pregnancy complications, and to connect you with qualified medical and support resources. You are not alone in navigating these difficult experiences.

Moving Forward

Maternal death and severe complications are among the most tragic outcomes in medicine because so many are preventable. Progress requires continued commitment to improving access to quality care, addressing health disparities, listening to women’s concerns, and learning from every loss.

If you are pregnant or planning to become pregnant, knowing your risk factors, attending prenatal appointments, speaking up about symptoms, and understanding warning signs can help protect your health. If you have experienced a complication or lost a loved one, know that support is available and that your experience matters in the broader effort to make pregnancy and childbirth safer for all families.

Maternal Death and Complications