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
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
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).
Changing Trends in Cause
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
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
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
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