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Maternal, Child & Adolescent Health Division

Publish Date

December 2023

For more information please visit CA-PMSS and Maternal Mortality pages.​

CA-PMSS Factsheet
Pregnancy-Related Mortality — 2018–2020

The California Pregnancy Mortality Surveillance System (CA-PMSS) provides the most accurate information on California’s pregnancy-related mortality — a key measure of population health. Pregnancy-related deaths are defined as deaths during pregnancy and up to one year after the end of pregnancy from causes related to or worsened by pregnancy or its management. Pregnancy-related deaths, as defined in CA-PMSS, exclude deaths due to suicide, homicide, drug overdose, or other injury. In 2018–2020, California had 1.3 million births and 208 pregnancy-related deaths.

By the Numbers

Pregnancy-Related Mortality in 2020

Pregnancy-related mortality ratio was 18.6 deaths per 100,000 live births in 2020 

California’s rate of pregnancy-related deaths increased in 2020 during the COVID-19 pandemic:

  • 45% higher than the rate of 12.8 deaths per 100,000 live births in 2019
  • 16% higher than the rate of 16.1 deaths per 100,000 live births in 2018

In 2020, about 1 in 5 pregnancy-related deaths was due to COVID-19.

Leading Causes in 2018-2020

Cardiovascular disease current leading cause of pregnancy-related deaths 

The leading causes of pregnancy-related mortality were cardiovascular disease (CVD), hemorrhage (HEM), infection (INF), thrombotic pulmonary embolism (TPE), amniotic fluid embolism (AFE), and hypertensive disorders of pregnancy (HDP).
Number of deaths CVD53 HEM36 INF3415 of 34 fromCOVID-19 TPE22 AFE19 HDP10

Changing Trends in Cause

45% decrease in pregnancy-related deaths from hypertensive disorders 

California’s rate of pregnancy-related deaths from hypertensive disorders decreased significantly.

The rate was 0.8 deaths per 100,000 live births in 2018–2020:

  • 45% lower than the rate of 1.4 deaths per 100,000 live births in 2015–2017

Disparities by Race/Ethnicity
Trends in 2018–2020

3.1 to 3.6 times higher rate of pregnancy-related deaths for Black birthing people 

Racial and ethnic disparities in pregnancy-related deaths decreased in 2018-2020 but persist. The rate for Black birthing people was 45.8 deaths per 100,000 live births in 2018–2020:

  • 3.1 to 3.6 times higher than the rates for Asian (15.0), Hispanic/Latino (14.8), and White birthing people (12.6)

In 2015–2017, the rate of pregnancy-related deaths for Black birthing people was 4.5 to 6.0 times higher.

Disparities by Health Insurance
Medi-Cal & Trends in 2018-2020

2.7 time higher rate of pregnacy-realted deaths with Medi-Cal health coverage 

The disparity in the rate of pregnancy-related deaths for birthing people with Medi-Cal health coverage and those with private health insurance widened in 2018–2020.

The rate for birthing people with Medi-Cal health coverage was 21.5 deaths per 100,000 live births in 2018–2020:

  • 2.7 times higher than the rate of 7.8 deaths per 100,000 live births for birthing people with private insurance

In 2015–2017, the rate of pregnancy-related deaths was 1.7 times higher for birthing people with Medi-Cal health coverage

Disparities by Community Conditions
Social Determinants & Trends in 2018-2020

2.1 times higher rate of pregnancy-related deaths when living in the lead healthy community conditions 

Disparities in the rate of pregnancy-related deaths persisted based on community conditions. Community conditions were measured using the Healthy Places Index.*

The rate for birthing people living in the least healthy community conditions was 18.9 deaths per 100,000 live births in 2018–2020:

  • 2.1 times higher than the rate of 9.2 deaths per 100,000 live births for birthing people living in the healthiest communities

In 2015–2017, the rate of pregnancy-related deaths was 1.7 times higher for birthing people living in the least healthy communities.

*Source: www.healthyplacesindex.org​​​​​​​​​​​​​​​​​​

 
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