How U.S. states’ maternal mortality compares globally

Axios – Monday, October 20, 2025
By Alex Fritzpatrick

Some U.S. states have maternal mortality rates similar to those of countries with relatively high numbers, a new analysis finds.

Why it matters: Comparing states with foreign nations can put health outcomes into a global — not just national — context.

By the numbers: Louisiana (41.9 deaths per 100,000 live births), Tennessee (31.3) and Arkansas (31.2) had the highest maternal mortality rates in 2023, per a new report from The Commonwealth Fund, a health care foundation.

Those figures are similar to countries such as El Salvador (39), Belize (31.6) and Azerbaijan (29.3).

California (9.5) and Washington (9.7) had the lowest rates in the U.S., similar to countries like Canada (9.4).

The overall U.S. maternal mortality rate was 18.6 in 2023, down from 22.3 a year prior.

What they’re saying: “Historically, states that invest more in health coverage, reproductive care, and social protections tend to have better health outcomes, in some cases on par with high-income countries,” the report says.

Meanwhile, “states that invest less and pass more restrictive policies have outcomes similar to low- and middle-income or politically unstable countries.”

Reality check: State-versus-country comparisons must also factor in variables like population size, economic activity, etc.

Between the lines: Maternal mortality varies widely between socioeconomic groups as well.

The rate for Black Americans is 50.3, for example, and 40.7 for American Indians and Alaska Natives.

How it works: The Commonwealth Fund’s analysis is based on a combination of data from the U.S. CDC, national health departments and the World Health Organization.

Maternal mortality is defined as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.”

Caveat: Some countries use varying methods to report maternal mortality, complicating direct comparisons.

What’s next: The U.S. Supreme Court overturning Roe v. Wade, plus Medicaid cuts, “will likely deepen coverage instability during pregnancy and after delivery, periods already marked by high rates of churn and care disruptions that contribute to poor maternal and infant health outcomes,” the report warns.

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