Research shows that maternal mortality—deaths related to pregnancy or giving birth—in the United States has increased in recent years and that U.S. rates are the highest among high-resource countries. Data also show that African American and American Indian/Alaska Native women are more likely than other U.S. groups to die from pregnancy, childbirth, or postpartum complications.

For each woman who dies, many more women experience short- and long-term health problems related to pregnancy or giving birth, called maternal morbidity.

To understand maternal morbidity and mortality, it’s important to know how different groups measure these issues and what the different terms mean.

Maternal Morbidity

Maternal morbidity describes unexpected short- or long-term health problems that result from being pregnant or giving birth. Some common conditions are cardiovascular disease, infection, bleeding, high blood pressure, and blood clots. These problems require additional medical care, such as hospitalization and long-term rehabilitation, and can affect a woman’s quality of life.

Maternal morbidity can include near-miss cases, meaning women almost die from pregnancy or giving birth but survive. Some women who have near-misses are left with serious lifelong health problems and disabilities. Near-miss cases are sometimes counted separately from general maternal morbidity.

Severe maternal morbidity (SMM)describes life-threatening health problems that are present at delivery. Researchers use 18 indicators, such as kidney failure and fluid in the lungs, to measure SMM.

Maternal Mortality

The short answer to “What is maternal mortality?” is that it is a measure of deaths related to pregnancy and giving birth. The longer answer is that researchers and healthcare providers use different methods to track these deaths and different terms to describe them. Some of these terms include the following:

• Maternal mortality or death refers to deaths that occur during pregnancy or within 6 weeks after the pregnancy ends that are related to pregnancy or its management. The World Health Organization (WHO) uses this description to report worldwide statistics.
• Pregnancy-related deaths refers to deaths during pregnancy and up to 1 year after the pregnancy ends that are related to pregnancy or pregnancy care. The Centers for Disease Control and Prevention (CDC) often uses this measure to report statistics for the United States. It also reports on maternal mortality using the WHO description.
• Pregnancy-associated deaths includes death during or in the year following pregnancy from causes not related to pregnancy, such as vehicle accidents, homicide, and suicide.

More research is needed to better understand the causes of these problems and deaths, the situations that contribute to them, and how to prevent them.

Most Pregnancy-Related Deaths are Preventable

Each year in the United States, about 700 women die during pregnancy or in the year after. Every pregnancy-related death is tragic, especially because most are preventable. Conditions such as weakened heart muscle, thrombotic pulmonary embolism, and high blood pressure contributed to a significantly higher proportion of pregnancy-related deaths among African American women than among white women.

Working Together to Reduce Disparities

To reduce disparities, multiple sectors need to work to address the factors contributing to these deaths.

Healthcare providers can:

• Help patients manage chronic conditions like diabetes, heart disease, high blood pressure and obesity.
• Communicate with patients about warning signs.
• Use tools to flag warning signs early so women can receive timely treatment.

Hospitals and healthcare systems can:

• Identify and address unconscious bias in healthcare.
• Standardize coordination of care and response to emergencies.
• Improve delivery of quality prenatal and postpartum care.
• Train non-obstetric providers to consider recent pregnancy history.

States and communities can:

• Assess and coordinate delivery hospitals for risk-appropriate care.
• Support review of the causes behind every maternal death.

Women and their families:

• Know and communicate about symptoms of complications.
• Note pregnancy history any time medical care is received in the year after delivery.

Certain factors increase a woman’s risk for maternal morbidity and mortality. In some cases, the woman and her healthcare provider may be able to change some of these factors to lower the risk. But not all factors can be changed. Additionally, some women experience maternal morbidity, severe maternal morbidity, near misses, or death without having any known risk factors.

Some factors that increase a woman’s risk for maternal morbidity and mortality include the following:

• Existing or pre-pregnancy health conditions, such as cardiovascular disease, obesity, asthma, or a compromised immune system
• Older maternal age
• Lifestyle factors, such as being a current or former cigarette smoker
• Having twins, triplets, or other multiples
• Certain pregnancy complications:
  • Preeclampsia, a spike in blood pressure after the 20th week of pregnancy, increases a woman’s risk for high blood pressure, blot clots, and stroke later in life.
  • Women who have gestational diabetes, high blood sugar during pregnancy, are at higher lifetime risk for diabetes (usually type 2) and for fatty liver disease.
• Certain features of giving birth:
  • An NICHD-funded study found that first-time moms who delivered vaginally were at higher risk for pelvic floor disorders.
  • Although vaginal birth after cesarean (VBAC) is safe for some women, women who had certain types of incisions are at higher risk for rupture of the uterus, a rare but serious problem, during VBAC. A rupture can lead to infection, bleeding, and other problems.
• Racial, ethnic, and socioeconomic backgrounds. Research shows disparities in the rates of maternal deaths in the United States, with black women and American Indian/Alaska Native women at highest risk for pregnancy-related death.

Many factors that increase a woman’s risk for maternal morbidity and mortality may also mean she has a high-risk pregnancy, one in which the mother, the fetus, or both are at higher risk for problems than a typical pregnancy. Healthcare providers may consider a pregnancy to be high-risk for reasons such as having twins or an existing health problem. Healthcare providers may adjust their care for a high-risk pregnancy to closely monitor the pregnancy.

Having one or more of these risk factors does not mean that a woman is certain to have health problems or that she will die during pregnancy or childbirth. Also, most women will not experience any complications in pregnancy.

Maternal mortality usually results from a pregnancy, delivery, or postpartum complication; a chain of medical events started by the pregnancy or delivery; the worsening of an unrelated condition because of the pregnancy or delivery; or other factors.

Maternal Mortality

According to the World Health Organization (WHO), the following cause the majority of maternal deaths around the world:

• Severe bleeding (sometimes called hemorrhage)
• Infections
• Blood pressure disorders of pregnancy, including preeclampsia and eclampsia
• Complications of labor and delivery
• Unsafe abortion

Infections and chronic medical conditions, such as diabetes, are also causes of or associated with maternal deaths worldwide.

In the United States, CDC tracks pregnancy-related deaths, including deaths that WHO calls “maternal mortality.” The leading causes of pregnancy-related death in the United States, according to CDC, are slightly different than maternal mortality causes around the world.

In the United States, the main causes of pregnancy-related deaths include the following:

• Severe bleeding (sometimes called hemorrhage)
• Infections and sepsis
• Cardiovascular conditions, such as:
  • Blockages (sometimes called embolisms) in arteries and veins
  • Stroke (also called cerebrovascular accidents)
  • Blood pressure disorders of pregnancy, including preeclampsia and eclampsia
  • Heart muscle problems (called cardiomyopathy)
  • Heart disease
• Problems with anesthesia
• Amniotic fluid embolism
• Non-cardiovascular conditions, such as diabetes and breathing problems

Many topics relevant to maternal morbidity and mortality, including the following:

• Breastfeeding and breast milk
• Diabetes (including gestational diabetes)
• High-risk pregnancy
• HIV/AIDS
• Labor and delivery
• Obesity and overweight
• Pelvic floor disorders
• Pelvic pain
• Preeclampsia and eclampsia
• Pre-pregnancy care and prenatal care
• Pregnancy
• Pregnancy loss
• Preterm labor and birth
• Stillbirth
• Stroke
• Women’s health
• Zika

It is hard to answer this question, because the causes of and situations surrounding maternal morbidity and mortality are complex. Because many factors play a role in maternal morbidity and mortality, there is no single way to prevent maternal health problems and deaths.

Improving maternal health could prevent many maternal deaths. Knowing about risk factors allows healthcare providers and pregnant women to work together to watch before, during, and after the pregnancy and birth; identify problems; and take steps to fix problems before they become serious. Doing so may reduce the risk of long-term problems and prevent death. Some research suggests that the majority of maternal deaths may be preventable.

For example, NICHD launched its Pregnancy for Every Body initiative, which educates plus-size pregnant women about working with their healthcare provider to increase their chances of healthy pregnancy and delivery. Pre-pregnancy and prenatal care can also help reduce risks.

But not all problems can be detected before they become serious. Some problems and risks are not related to specific behaviors or chronic conditions and cannot be detected, prevented, or treated. In some cases, serious health problems and deaths may occur without any warning signs, meaning there is nothing a woman or her healthcare provider could do to prevent them.

Research that advances our understanding of pregnancy and childbirth eventually will help improve maternal healthcare, inform treatments, and potentially allow healthcare providers to identify and address complications before they become serious.

At the same time, healthcare providers, hospitals and health systems, families, and pregnant women are working to reduce maternal morbidity and mortality. Some of these activities include the following:

• Creating review committees to examine causes of maternal death
• Sharing safety checklists at hospitals, clinics, and provider offices
• Improving access to high-quality healthcare
• Alerting women about signs and symptoms of complications that could become serious

Worldwide, the majority of maternal deaths occur in developing countries, where women have little or no access to healthcare services. Reducing maternal mortality and morbidity is a priority for many national departments of health and for international organizations, including the World Health Organization (WHO).

The death of a woman during pregnancy, at delivery, or soon after delivery is a tragedy for her family and for society as a whole. Sadly, about 700 women die each year in the United States as a result of pregnancy or delivery complications.

During pregnancy, a woman’s body goes through many changes. These changes are entirely normal, but may become very important in case there are complications or problems.

A pregnancy-related death is defined as the death of a woman during pregnancy or within one year of the end of pregnancy from a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy.

What can women do to prevent a pregnancy-related death?

Many factors influence pregnancy-related health outcomes. It is important for all women of reproductive age to adopt healthy lifestyles (e.g., maintain a healthy diet and weight, be physically active, quit all substance use, prevent injuries) and address any health problems before getting pregnant. Visit your health care provider to discuss if or when you are thinking about getting pregnant. This is important to make sure you receive appropriate medical advice and care, and have healthy pregnancies.

A healthy pregnancy begins before conception and continues with prenatal care, along with early recognition and management of complications if they arise. Health care providers can help women prepare for pregnancy and for any potential problems during pregnancy. Early initiation of prenatal care by pregnant women, and continuous monitoring of pregnancy by health providers, are key to helping to prevent and treat severe pregnancy-related complications.

Did you know some problems due to pregnancy can happen up to a year after delivery? Be aware of urgent maternal warning signs and symptoms during pregnancy and in the year after delivery. Seek medical care immediately if you experience any signs or symptoms that are listed below. These symptoms could indicate a life-threatening situation.

The following list was developed by the Council on Patient Safety in Women’s Health Care. Learn about these urgent maternal warning signs below.

Headache that won’t go away or gets worse over time

• Feels like the worst headache of your life
• Lasts even after treatment with medication and fluid intake
• Starts suddenly with severe pain – like a clap of thunder
• Throbs and is on one side of your head above your ear
• Comes with blurred vision or dizziness

Dizziness or fainting

• You faint or pass out
• You have dizziness and lightheadedness that’s ongoing, or comes and goes over many days
• You experience a gap in time of which you have no memory

Changes in your vision

• You see flashes of light or bright spots
• You have blind spots or you can’t see at all for a short time
• Your vision is blurry, you can’t focus, or you’re seeing double

Fever of 100.4°F or higher

• You have a temperature of 100.4°F (38°C) or higher

Extreme swelling of your hands or face

• Swelling in your hands makes it hard to bend your fingers or wear rings
• Swelling in your face makes it hard to open your eyes all the way—they feel and look puffy
• Your lips and mouth feel swollen or you have a loss of feeling

This swelling is not like the usual slight swelling that most moms have during pregnancy, especially during the last few months of pregnancy.

Thoughts about harming yourself or your baby

• You may think about hurting yourself because you:
  • Feel very sad, hopeless, or not good enough
  • Don’t feel that you have control over your life
  • Feel extremely worried all the time
• You may think about hurting your baby and/or you may have scary thoughts that come when you don’t want or that are hard to get rid of

Trouble Breathing

• You feel short of breath suddenly or over time, as if you can’t breathe deeply enough to get enough air in your lungs
• Your throat and/or chest feel tight
• You have trouble breathing when you’re laying down flat, such as needing to prop your head up with pillows to sleep

Chest pain or fast-beating heart

• You have chest pain, such as:
  • A feeling of tightness or pressure in the center of your chest
  • Pain that travels to your back, neck, or arm
• You have a change in your heartbeat, such as:
  • A fast heartbeat or a pounding in your chest
  • An irregular heart rate or skipped heartbeats
• You feel dizzy, faint, or disoriented
• You have trouble catching your breath (talking and breathing are difficult)

These symptoms can happen at any time and anywhere or may be triggered by a specific event.

Severe nausea and throwing up

• You feel severely sick to your stomach (nauseous) beyond the normal queasy feeling and throwing up that many moms have in early pregnancy
• You are unable to drink for more than 8 hours or eat for more than 24 hours
• You throw up and can’t keep water or other fluids in your stomach
• You have:
  • A dry mouth
  • Headaches
  • Confusion
  • Fever
  • Dizziness or lightheadedness

Severe belly pain that doesn’t go away

• You have a sharp, stabbing, or cramp-like belly pain that doesn’t go away
• Your belly pain starts suddenly and is severe, or gets worse over time
• You have severe chest, shoulder, or back pain

Baby’s movement stopping or slowing during pregnancy

• You feel that your baby has stopped moving or your baby is moving less than before.

There is no specific number of movements that is considered normal, a change in your baby’s movement is what is important.

Vaginal bleeding or fluid leaking during pregnancy

• You have any bleeding from your vagina that is more than spotting – like a period
• You have fluid leaking out of your vagina
• You have vaginal discharge that smells bad

Vaginal bleeding or discharge after pregnancy

• You have heavy bleeding – soaking through one or more pads in an hour
• You pass clots bigger than an egg or you pass tissue
• You have vaginal discharge that smells bad

Severe swelling, redness or pain of your leg or arm

Anytime during pregnancy or up to 6 weeks after birth

• You have swelling, pain, or tenderness in your leg – usually your calf or in one leg:
  • It may or may not hurt when you touch it
  • It may hurt when you flex your foot to stand or walk
  • The painful area can also be red, swollen, and warm to the touch
• You have pain, tenderness or swelling in your arm, usually on just one side of your body

Overwhelming tiredness

• You are suddenly very tired and weak, not like chronic fatigue
• You don’t have enough energy to go about your day
• No matter how much you sleep, you don’t feel refreshed
• You feel so tired that you don’t get up to take care of your baby
• You feel sad after having your baby

This list is not meant to cover every symptom you might have. If you feel like something just isn’t right, or you aren’t sure if it’s serious, talk to your healthcare provider. Be sure to tell them if you are pregnant or were pregnant within the last year.

If you are pregnant or gave birth within a year, learn more about how to talk to your healthcare provider.

The Hear Her campaign features compelling stories from women about their experiences during or after pregnancy. They share how pregnancy-related complications or conditions have affected them and how they got help.

Black women are 3 times more likely to die from a pregnancy-related complication than White women.

Hear Allyson’s Story

Allyson is an elite track and field athlete and Olympian who was diagnosed at 32-weeks pregnant with severe preeclampsia – a potentially life-threatening, pregnancy-related complication. Given her exceptional level of fitness and extensive training, she was surprised to learn during a prenatal visit that she had elevated levels of protein in her urine and had developed high blood pressure. Her doctor admitted her into the hospital for further monitoring and testing. She was then sent for an emergency C-section. Her doctor’s fast actions may have saved her life.

Black women are 3 times more likely to die from a pregnancy-related complication than White women.

Allyson’s story is not unique. As many as 50,000 women experience severe, unexpected health problems related to pregnancy each year. Some may have long-term health consequences, and others may not survive. Over 700 women die each year in the U.S. from problems related to pregnancy or delivery complications. Every death is a tragedy, especially when we know that two-thirds of pregnancy-related deaths could have been prevented.

Allyson felt prepared—she is a professional athlete, had a birth plan, went to prenatal appointments, attended birthing classes, and trained throughout her pregnancy. She never imagined that she would experience a serious problem during her pregnancy. Yet with two months to go until her due date, she was diagnosed with severe preeclampsia and had to be admitted immediately to the hospital, resulting in an emergency C-section.

Her daughter, Camryn, was born at 3 pounds, 7 ounces and had to spend her first month of life in the neonatal intensive care unit. Thankfully, Camryn is now a healthy, growing toddler, and Allyson is a healthy, proud mom and a champion for maternal health. She is also focused on raising awareness of the higher burden of poor pregnancy outcomes among Black women, in hopes of helping generate change.

Allyson joined CDC’s Hear Her campaign to share her story and help educate women and all who support them about the urgent warning signs of pregnancy-related complications.

“I really want women to be aware, to know if they’re at risk, to have a plan in place, to not be intimidated in doctor’s offices, and to be heard. To know the signs and be persistent about anything that does not feel normal.”

Eleorra had severe chest pains during pregnancy and knew “Something didn’t feel right.” She kept searching for answers and finally found a high-risk doctor who provided her with the care she needed to make it through her pregnancy safely.

Kylie’s pregnancy progressed normally until 38 weeks when she began to experience swelling. Soon after, she developed life-threatening complications, culminating in a stay in the ICU, dialysis, and an eventual kidney transplant. Kylie’s husband was her “lifeline” fighting for her and making sure she got the best care possible.

Lindsay is a mother of four who developed preeclampsia during her second pregnancy. In response to her symptoms she was told that she was experiencing typical pregnancy swelling. But when her headache and blurred vision got worse, she checked her blood pressure at a pharmacy and discovered it was dangerously high. Lindsay went straight to the hospital, a decision that may have saved her life.

Mona experienced extreme swelling and a fast-beating heart. Hear more about how her midwives, doulas and family supported her and helped her get the care she needed.

Mona’s story is filmed in Taos Pueblo, on the traditional homelands of the Red Willow People. We thank the people of Taos Pueblo for welcoming us to tribal land to share Mona’s story.

Sanari started to experience pain two days after delivery and was initially told it was caused by gas. But when her symptoms continued to worsen, she knew something was wrong. An abscess was eventually found on her uterus, which could have been fatal. “I’m glad I didn’t stop at no,” she says. “I’m glad someone finally listened to me.”

Sarah shares her experience with postpartum depression.

“Once you let it out and once you tell someone, that person that you trust can help you find some help.”

Sarah’s story was filmed in Tulsa, Oklahoma, on the traditional lands of the Osage, Caddo, Muscogee Creek, and Cherokee Tribal Nations.

Hear Takayla’s story of her experience with preeclampsia. Takayla sought medical care after experiencing urgent maternal warning signs.

“If they had waited any longer or if I hadn’t gone to the hospital or been an active participant in my pregnancy, I could have died.”

Takayla’s story was filmed in Minnesota, on the traditional lands of the Dakota and Anishinaabe people.

“I felt like nobody understood or cared.”

Trivia experienced postpartum depression after her first pregnancy, when her provider did not respect her cultural practices or listen to her concerns. Her story shares the importance of culturally appropriate care, and she advises women to find a provider they are comfortable with.

Trivia’s story was filmed in South Dakota, on the ancestral, traditional, and contemporary lands of the Oceti Sacowin, or Seven Council Fires.

Valencia struggled with headaches and dizziness during a difficult first pregnancy. When she reported worsening symptoms, she felt like no one heard her or took her seriously. She didn’t know who to talk to and wasn’t sure how to speak up for herself. It was her primary care provider who finally helped her get the care she needed.

If you are pregnant or gave birth within the last year, it’s important to talk to your healthcare provider about anything that doesn’t feel right. It may be physical, but it could also include feelings of sadness, anxiety, and exhaustion that make it difficult to complete daily care activities for yourself, your baby or others.

You know your body best. If you experience something that seems unusual or is worrying you, don’t ignore it. Talk to your healthcare provider.

During Pregnancy

Discuss your health history with your doctor during your pregnancy and make a plan for managing any potential problems that may arise based on your risk factors.

After Pregnancy

While your new baby needs a lot of attention and care, it’s important to remain aware of your own body and take care of yourself, too. It’s normal to feel tired and have some pain, particularly in the first few weeks after having a baby, but there are some symptoms could be signs of more serious problems.

Talk to Your Healthcare Provider

When discussing concerns with your healthcare provider, it is important to say you are pregnant or were recently pregnant. Describe any other health conditions like high blood pressure or diabetes, along with any complications you experienced with your pregnancy or delivery. If you can, bring a friend or family member with you for support and to help you ask the questions you need answered.

Urgent Maternal Warning Signs

• Severe headache
• Dizziness or fainting
• Changes in your vision
• Fever
• Trouble breathing
• Overwhelming tiredness
• Chest pain
• Severe belly pain
• Severe nausea and throwing up
• Severe swelling
• Thoughts about harming yourself or your baby

If you experience an urgent maternal warning sign during or after pregnancy, get medical care immediately.

Having a healthy pregnancy is one of the best ways to promote a healthy birth. Getting early and regular prenatal care improves the chances of a healthy pregnancy. This care can begin even before pregnancy with a pre-pregnancy care visit to a health care provider.

Pre-Pregnancy Care

A pre-pregnancy care visit can help women take steps toward a healthy pregnancy before they even get pregnant.
Women can help to promote a healthy pregnancy and birth of a healthy baby by taking the following steps before they become pregnant:

• Develop a plan for their reproductive life.
• Increase their daily intake of folic acid (one of the B vitamins) to at least 400 micrograms.
• Make sure their immunizations are up to date.
• Control diabetes and other medical conditions.
• Avoid smoking, drinking alcohol, and using drugs.
• Attain a healthy weight.
• Learn about their family health history and that of their partner.
• Seek help for depression, anxiety, or other mental health issues.

Prenatal Care

Women who suspect they may be pregnant should schedule a visit to their health care provider to begin prenatal care. Prenatal visits to a health care provider usually include a physical exam, weight checks, and providing a urine sample. Depending on the stage of the pregnancy, health care providers may also do blood tests and imaging tests, such as ultrasound exams. These visits also include discussions about the mother's health, the fetus's health, and any questions about the pregnancy.

Pre-Pregnancy and prenatal care can help prevent complications and inform women about important steps they can take to protect their infant and ensure a healthy pregnancy. With regular prenatal care women can:

• Reduce the risk of pregnancy complications. Following a healthy, safe diet; getting regular exercise as advised by a health care provider; and avoiding exposure to potentially harmful substances such as lead and radiation can help reduce the risk for problems during pregnancy and promote fetal health and development. Controlling existing conditions, such as high blood pressure and diabetes, is important to prevent serious complications and their effects.

• Reduce the fetus's and infant's risk for complications. Tobacco smoke and alcohol use during pregnancy have been shown to increase the risk for Sudden Infant Death Syndrome. Alcohol use also increases the risk for fetal alcohol spectrum disorders, which can cause a variety of problems such as abnormal facial features, having a small head, poor coordination, poor memory, intellectual disability, and problems with the heart, kidneys, or bones. According to one recent study supported by the NIH, these and other long-term problems can occur even with low levels of prenatal alcohol exposure.
  
  In addition, taking 400 micrograms of folic acid daily reduces the risk for neural tube defects by 70%. Most prenatal vitamins contain the recommended 400 micrograms of folic acid as well as other vitamins that pregnant women and their developing fetus need. Folic acid has been added to foods like cereals, breads, pasta, and other grain-based foods. Although a related form (called folate) is present in orange juice and leafy, green vegetables (such as kale and spinach), folate is not absorbed as well as folic acid.

• Help ensure the medications women take are safe. Women should not take certain medications, including some acne treatments and dietary and herbal supplements, during pregnancy because they can harm the fetus.

What is mental health?
Mental health affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make healthy choices.

What is maternal mental health?
Maternal mental health is the range of feelings you can have during and after pregnancy. Pregnancy and the postpartum period (time after delivery) can bring on lots of strong emotions, and some may feel:

• Overwhelmed
• Sad
• Worried
• Exhausted
• Concerned they aren't good enough as a mom

For many individuals, these feelings go away on their own. But, for some, these emotions are more serious and may stay for months. If you're not feeling yourself for more than two weeks, make sure to reach out and find help. Difficulties such as depression and anxiety around pregnancy and after the baby is born are common and treatable. They affect new parents of every culture, age, gender, race, and income level.

What are some signs of depression and anxiety during and after pregnancy?
Depression and anxiety affect pregnant people and new parents in different ways. Here are some of the common symptoms:

• Feeling sad or hopeless most of the time
• Lack of interest in things you used to enjoy
• Less interest in caring for yourself (dressing, fixing hair)
• Trouble concentrating
• Trouble coping with daily tasks
• Constant worry about your baby
• Sleeping or eating too much or too little
• Feeling very anxious or nervous
• Unexplained irritability or anger
• Unwanted or scary thoughts
• Feeling that you are not a good mother
• Thoughts of hurting yourself or your baby

If you are experiencing any of these symptoms, please call or text the National Maternal Mental Health Hotline at 1-833-943-5746 (1-833-9-HELP4MOMS). Don't wait. Reach out today.

What should I do if I need help right away?
You don’t need a diagnosis to reach out for support. Reach out as soon as possible, and talk to supportive and informed counselors.

The National Maternal Mental Health Hotline provides 24/7, free, confidential support, resources, and referrals to any pregnant and postpartum mothers facing mental health challenges and their loved ones, via phone and text in English and Spanish. Call or text 1-833-943-5746 (1-833-9-HELP4MOMS.)

If a loved one experiences an urgent maternal warning sign during or within a year after pregnancy, get medical care immediately.

Your pregnant or recently pregnant friend or family member is going through many changes. Changes are normal but some could be warning signs for complications or more serious problems.

It may be physical, but also includes feelings of sadness, anxiety, and exhaustion that make it difficult to complete daily care activities for herself, her baby or others. It’s important to really Hear Her concerns when she expresses them to you and encourage her to seek help, if needed. Serious pregnancy-related complications and deaths can occur, but many can be prevented if we recognize the warning signs and encourage women to get help early.

How can you help?

• Learn the urgent maternal warning signs.
• Listen to her concerns.
• Encourage her to seek medical help. If something doesn’t feel right, she should reach out to her provider. If she is experiencing an urgent maternal warning sign, she should get medical care right away. Be sure that she says she is pregnant or was pregnant within the last year.
• Offer to go with her to get medical care and help her ask questions.
• Take notes and help her talk to a healthcare provider to get the support she needs.
• Support her through follow-up care.

Starting the Conversation

If your loved one shares that something doesn’t feel right, support her to get the care and answers she may need. Learn the urgent warning signs that need immediate medical attention. See "Urgent Maternal Warning Signs"

An estimated 700 U.S. women die each year from conditions related to or associated with pregnancy or childbirth, the highest maternal mortality rate among developed nations. In addition, more than 50,000 women experience severe maternal morbidity (SMM), life-threatening health problems that are present during labor and delivery that can cause significant short- and long-term health problems for mothers.

The NIH-wide IMPROVE initiative supports research on how to reduce preventable maternal mortality, decrease SMM, and promote health equity. Using an integrated approach to understand biological, behavioral, sociocultural, and structural factors contributing to maternal mortality, SMM, and maternal morbidity, including a focus on the ongoing COVID-19 pandemic, the IMPROVE initiative will build an evidence base for improved care and outcomes in specific populations and regions of the country.

This multipronged, innovative research initiative is designed to understand and reduce health disparities among populations disproportionately affected by maternal morbidity and mortality, including African American, American Indian/Alaska Native, Asian/Pacific Islander, Hispanic/Latina, very young women, older women, and women with disabilities. Many of these populations are also disproportionately affected by the COVID-19 pandemic. The IMPROVE approach also addresses geographic disparities and social determinants of health, including education, racism, and socioeconomic standing.

Initiative Goals

The IMPROVE initiative aims to:

• Address the foremost causes of maternal mortality in the United States, which include cardiovascular disease, infection, embolism, and immunity—as well as significant pregnancy-associated and pregnancy-related health complications, such as diabetes, obesity, mental health disorders, and substance use disorders.
• Identify biological, behavioral, sociocultural, and structural factors that contribute to disparities in maternal health and delays or disruptions in maternal care.
• Investigate the potential effects of emerging infections, such as SARS-CoV-2, on pregnancy-related deaths and complications in different geographic regions and communities.
• Support the development of technologies, tools, devices, and interventions that predict or diagnose risk for maternal morbidity and mortality, reduce preventable causes of maternal deaths and improve health with a focus on mitigating maternal health disparities.
• Help create tailored, evidence-based maternal health-related solutions for women across the country to promote maternal health equity