Maternal & Infant Mortality

The CDC tracks pregnancy-related deaths through state vital records, and the 2022 release put the national rate at 22.3 per 100,000 live births. To frame what that number means in international terms, Norway recorded zero maternal deaths that year. Sweden was at 5 per 100,000. Switzerland at 1.2.

The US rate sits closer to Iran and Ukraine than to its peer countries. The CDC counts deaths during pregnancy and within 42 days of birth from any cause related to or worsened by the pregnancy, which matches the WHO definition, so the comparison is honest.

One reasonable caveat: the US number partly reflects better tracking after 2018, when every state added a pregnancy checkbox to death certificates. Even adjusting for that, the rate is more than five times Sweden's. The number has been rising while every other rich country has been pushing theirs down.

The Commonwealth Fund is a private healthcare foundation that publishes cross-country health system comparisons. Their 2024 maternal health report ranked the United States last among high-income nations. American mothers die at four to seven times the rate of mothers in Norway, Sweden, the Netherlands, and Japan.

The US spends about 17 percent of GDP on healthcare, the highest in the world, and runs maternal mortality numbers that look closer to countries spending three to four percent. The report breaks deaths down by when they happen. Most US maternal deaths happen postpartum, often weeks after the hospital discharge.

The countries that do better tend to share a few things: universal midwifery, longer postpartum follow-up, and no financial incentive to push mothers out of the hospital fast. The report does not argue for any one policy fix. It just lays out the pattern.

In April 2025, Harvard's news outlet published an analysis of pregnancy-related death trends across high-income nations. Every other wealthy country has been pushing maternal mortality down for decades. The US is the only one moving in the opposite direction. The rate has roughly doubled since 1987.

Most of the increase shows up in hypertensive disorders, cardiovascular events, and overdose deaths, but the deeper system factors behind those proximate causes are what researchers at the Harvard T.H. Chan School of Public Health point to in the piece. Postpartum follow-up is sparse compared with Europe.

Many women lose insurance coverage within two months of giving birth. Rural maternity wards have been closing for over a decade, creating large maternity deserts where the nearest delivery hospital can be over an hour away. The reporting pulls data from the CDC's vital statistics releases.

The OECD publishes annual infant mortality rankings across its 38 member countries. The most recent release puts the United States 33rd out of 38, at 5.1 infant deaths per 1,000 live births.

Sweden sits at 2.1, Norway at 1.6, Japan at 1.8, Iceland and Estonia below 2 as well. The US rate is roughly three times higher than the Scandinavian average. About two-thirds of US infant deaths happen in the first month of life, often from prematurity-related complications.

The US does have a higher preterm birth rate than its peers, which explains part of the gap. But Scandinavian countries with similar preterm rates still produce better outcomes on infant survival, which means the gap is not just about who is being born early. It is about what happens to those babies and their mothers in the months around birth.

The CDC tracks maternal and infant mortality by race using the same vital records that produce the headline national numbers. The disparities are extreme and have been for as long as the data has been collected.

Black women in the US die at 49.5 per 100,000 live births, roughly 2.6 times the rate for white women and nearly 50 times the rate for women in Norway. Black infants die at 10.97 per 1,000, more than double the national average of 5.1.

What is striking, and what makes this hard to dismiss as a poverty story, is that the gaps persist after controlling for income, education, and access to prenatal care. Affluent and college-educated Black women still face rates that look closer to developing-world numbers. Studies in JAMA and the American Journal of Obstetrics & Gynecology have documented that Black women receive less pain medication, are less likely to be believed about symptoms, and report being ignored by providers more often than other groups.

AJMC, a managed care journal, published an analysis that combines Commonwealth Fund data on healthcare spending with CDC mortality numbers. The result is a paradox that has repeated itself across nearly every recent study of the US system. The United States spends roughly twice per capita what Sweden or Norway spend on healthcare, runs the most advanced obstetric infrastructure in the world by any technological measure, and produces the worst maternal and infant outcomes of any high-income country.

The article walks through the usual candidate explanations, including fragmented postpartum care, the dominance of intervention-heavy hospital birth, the absence of universal midwifery, and the lack of paid maternity leave. None of those alone account for the full gap. The pattern is now consistent enough across datasets that researchers have stopped treating it as a question of resources and started treating it as a question of system design.