Tennessee Tops U.S. Maternal Mortality Rates in New Study

A new study from Harden Crichton, P.C. finds wide state-by-state gaps in maternal mortality, with Tennessee nearly four times higher than California among the 39 states with published data. The findings also point to sharp racial disparities and preventability concerns in Pennsylvania.

Why it matters: - Maternal mortality rates vary sharply by state, showing that where a woman lives can affect pregnancy risk. - Tennessee’s rate was 41.1 deaths per 100,000 live births, nearly four times California’s 10.5. - The study also underscores that lower-than-average state rates can still hide preventable deaths. - Racial disparities remain stark, with the CDC reporting a 2024 maternal mortality rate of 44.8 for non-Hispanic Black women versus 14.2 for non-Hispanic white women.

What happened: - Harden Crichton, P.C. published a nationwide study examining CDC maternal mortality data from 39 states with published rates between 2018 and 2022. - Tennessee had the highest published maternal mortality rate among those states, followed by Mississippi at 39.1, Alabama at 38.6, Arkansas at 38.3 and Louisiana at 37.3. - California recorded the lowest published rate at 10.5. - Pennsylvania ranked 31st out of the 39 states, with a rate of 17.5 maternal deaths per 100,000 live births and 116 deaths over the five-year period.

The details: - Tennessee’s rate was 77% above the national rate of 23.2 and represented 166 maternal deaths from 2018 through 2022. - California’s rate means Tennessee’s figure was nearly four times higher during the same period. - Pennsylvania’s Maternal Mortality Review Committees found that 41 of 42 pregnancy-related deaths in 2021, or 98%, were preventable. - The CDC defines a maternal death as the death of a woman while pregnant or within 42 days after the end of pregnancy from a cause related to or aggravated by the pregnancy, excluding accidental or incidental causes. - Pennsylvania defines a preventable death as one with at least some chance of being avoided through reasonable changes involving patient, family, provider, facility, system or community factors. - The Pennsylvania review committees said a preventability finding is not the same as a legal finding of medical malpractice. - Kevin Harden Jr., a Philadelphia trial attorney and co-founder of Harden Crichton, P.C., said the figures show maternal mortality remains a serious concern even in states below the national average.

Between the lines: - The study suggests state averages can mask local failures in care, because Pennsylvania’s rate sat below the national figure while its review committees still found most 2021 pregnancy-related deaths were preventable. - The racial gap reported by the CDC points to persistent inequities in maternal health outcomes, not just geographic differences. - The data frame maternal mortality as both a public health issue and a systems issue involving providers, facilities and support networks.

What's next: - The study’s authors and reviewers appear to be pushing for closer scrutiny of maternal care practices, especially around preventable deaths. - State-level and facility-level reviews may continue to shape how hospitals and policymakers identify risk and improve outcomes. - The full study is available in Harden Crichton, P.C.'s report.

The bottom line: - Maternal mortality remains uneven across the U.S., and the biggest danger may be not only higher rates in some states but also preventable deaths in places that look safer on average.