Understanding the health and financial impact of maternal morbidity on U.S. families

Maternal death is not the only measure of whether our maternity care system is keeping women safe.

For every mother who dies from pregnancy-related causes, many more survive complications that can affect their health, ability to work, finances, families, and children long after they leave the hospital.

This is maternal morbidity, and understanding it is essential to understanding the full impact of maternal health in the United States.

A mother does not have to die for pregnancy or childbirth to have a serious and lasting impact on her health. Some women survive complications that require emergency treatment, surgery, prolonged hospitalization, or ongoing medical care. Others experience physical or psychological consequences that continue long after they leave the hospital.

For families, the effects can extend even further.

What Is Maternal Mortality?

Maternal mortality refers to deaths occurring during pregnancy or after pregnancy from causes related to or aggravated by pregnancy or its management.

Different public health measures define maternal deaths differently. Some focus on deaths during pregnancy or within 42 days after pregnancy, while pregnancy-related mortality surveillance may include deaths occurring up to one year after pregnancy when the death was caused or aggravated by pregnancy or its management.

Maternal mortality represents the most devastating end of the maternal health spectrum and is an important measure of the health and safety of maternity care systems.

According to the Centers for Disease Control and Prevention, 649 women died of maternal causes in the United States in 2024, compared with 669 in 2023. The maternal mortality rate for 2024 was 17.9 deaths per 100,000 live births, which was not significantly lower than the 2023 rate of 18.6 deaths per 100,000 live births.

But deaths represent only one part of the maternal health picture.

What is Maternal Morbidity?

Maternal morbidity is a much broader category. It refers to health problems that occur during pregnancy, childbirth, or the postpartum period, as well as conditions that may be worsened by pregnancy.

Some complications resolve after treatment. Others can have consequences that last for months or years.

Severe maternal morbidity, or SMM, is different.

SMM is a narrower public health measure used to identify particularly serious and unexpected complications associated with pregnancy and childbirth that can have significant short- or long-term health consequences.

The Centers for Disease Control and Prevention currently uses 21 indicators to identify SMM in hospital data. These include conditions such as acute kidney failure, cardiac arrest, amniotic fluid embolism, respiratory distress syndrome, and other serious complications.

In simpler terms, maternal morbidity describes illness, injury, or health complications associated with pregnancy and childbirth. Severe maternal morbidity describes a narrower group of particularly serious complications.

Not every maternal morbidity qualifies as severe maternal morbidity.

What Can Maternal Morbidity Look Like?

Maternal morbidity encompasses a wide range of conditions and experiences. Examples may include:

• Severe bleeding, or hemorrhage, during or after childbirth
• Hypertensive disorders, including severe high blood pressure and preeclampsia
• Gestational diabetes
• Sepsis and other serious infections
• Blood clots, or venous thromboembolism
• Amniotic fluid embolism
• Cardiac complications
• Kidney complications
• Maternal mental health conditions, including postpartum depression, anxiety, and other significant mental health conditions

These conditions vary substantially in severity. Some may qualify as severe maternal morbidity, while others may not.

Importantly, experiencing a pregnancy complication does not automatically mean that something went wrong in a mother’s medical care.

Complications can occur even when appropriate medical care is provided. Whether a particular injury or complication resulted from medical negligence is a separate legal question that requires examining the applicable standard of care, whether that standard was breached, whether the breach caused injury, and the resulting damages.

What Does Maternal Morbidity Cost in the United States?

The effects of maternal morbidity extend beyond physical health.

A 2022 study published in PLOS ONE, titled “Societal Cost of Nine Selected Maternal Morbidities in the United States,” attempted to quantify some of that impact.

Researchers estimated the societal costs associated with nine selected maternal morbidities for the 2019 U.S. birth cohort, tracking outcomes from conception through five years postpartum.

One of the strengths of this study is that it looked beyond hospital bills.

The researchers considered both:

• Medical costs, including hospital stays and other healthcare expenses; and
• Nonmedical costs, including missed work, productivity losses, and social services.

Their estimate was substantial.

The nine selected maternal morbidities were associated with an estimated $32.3 billion in societal costs for the 2019 U.S. birth cohort, or approximately $8,624 per birthing person and child.

Researchers estimated approximately $18.7 billion in medical costs and $13.6 billion in nonmedical costs. About two-thirds of the total costs occurred during the first year after birth.

Importantly, $32.3 billion is not an estimate of the cost of all maternal morbidity in the United States.

The researchers examined only nine selected conditions. The study did not include every maternal morbidity or every potential long-term consequence, meaning the overall societal burden may be considerably greater.

Which Conditions Drove the Largest Costs?

Among the nine maternal morbidity conditions included in the study, the largest estimated total costs were associated with:

• Maternal mental health conditions: $18.1 billion
• Hypertensive disorders: $7.5 billion
• Gestational diabetes mellitus: $4.8 billion
• Hemorrhage: $1.8 billion

One of the most striking findings is the role of maternal mental health.

In this model, maternal mental health conditions were not a secondary or insignificant component of maternal morbidity. They represented the largest estimated cost driver among the conditions studied.

That matters when we think about what maternal recovery actually means.

Physical survival is only one measure of maternal health. Mental health conditions can affect a mother’s ability to work, care for herself, care for her children, maintain relationships, and participate in daily life.

The Hidden Cost: When the Impact Reaches the Child

The researchers also looked beyond outcomes affecting mothers.

Because this was a societal-cost model, the analysis included certain downstream outcomes affecting children that were associated with the maternal conditions studied.

Approximately 74% of the estimated costs, or about $24 billion, were associated with child outcomes, while approximately 26%, or $8.3 billion, were associated with maternal outcomes.

Among the largest child-related costs identified in the model were:

• Preterm birth: approximately $13.7 billion
• Developmental disabilities: approximately $6.5 billion
• Respiratory distress syndrome: approximately $2.1 billion

This illustrates why maternal morbidity cannot always be viewed as an issue affecting only the mother.

A serious maternal health condition may affect pregnancy outcomes, a child’s health, a parent’s ability to work, and the resources available to the entire family.

The study also estimated approximately $6.6 billion in productivity losses associated with maternal outcomes, along with costs related to cesarean deliveries and increased hospital stays.

The Effects May Continue Long After the Hospital

Giving birth and being discharged from the hospital does not necessarily mean that the consequences of maternal morbidity are over.

A mother recovering from a serious hemorrhage may require additional treatment and months of physical recovery.

Someone who experienced a severe hypertensive disorder may require continued monitoring and medical care.

A mother experiencing a significant mental health condition may require therapy, medication, additional support, or time away from work.

And a family caring for a child affected by a pregnancy-related complication may face additional medical, developmental, educational, and caregiving needs.

The study tracked costs through five years after birth, but the researchers emphasized that their estimate likely represents only part of the true cost. Their analysis covered nine selected conditions and did not capture every maternal morbidity or all possible lifetime consequences.

Depending on the assumptions used regarding prevalence and the effects of the conditions studied, researchers estimated that total costs could range from approximately $12.1 billion to $57.6 billion.

The Part We Don’t Talk About Enough

As a maternal injury and birth injury lawyer, this is the part of maternal morbidity that I think is too easily overlooked.

Survival is obviously the first and most important goal. But surviving a serious pregnancy or childbirth complication does not necessarily mean returning to the life you had before it happened.

I have seen how maternal injuries can affect a woman’s ability to care for her children, return to work, have additional children, maintain financial stability, and simply feel like herself again.

Those consequences matter too.

A serious maternal complication can ripple through an entire family. There may be missed work, additional childcare needs, medical appointments, therapy, financial strain, changes in family planning, and months or years of recovery.

Those consequences may be difficult to capture in a single statistic, but they are very real to the families experiencing them.

Why Maternal Morbidity Matters

Maternal mortality is an essential measure of maternal health, and reducing preventable maternal deaths must remain an urgent priority.

But mortality cannot be the only measure we use to determine whether mothers are doing well.

Focusing only on deaths can leave out the many women who survive serious complications and continue living with their consequences.

Survival matters. But survival cannot be our only measure of success.

A mother may leave the hospital alive and still face months or years of physical recovery, psychological trauma, lost income, additional medical care, disability, or changes to her ability to work and care for her family.

And when a serious maternal complication affects a child’s health or a family’s ability to function, those consequences can extend far beyond the delivery room.

Reducing maternal morbidity isn’t only about improving women’s health.

It supports children and families. It reduces strain on workplaces and healthcare systems. And it strengthens communities.

Maternal health is an everyone issue.

Disclaimer

This article is for general educational purposes only and is not medical or legal advice. Every pregnancy, birth, and postpartum experience is different.

If you or someone you love is experiencing concerning postpartum symptoms, whether physical or mental, seek appropriate medical care. If you believe a serious maternal injury may have involved preventable errors in medical care, consider speaking with a qualified attorney about your individual circumstances.