Birth and Pregnancy

 

State of Birth in America

TRIGGER WARNING: Below you can find the most recent and comprehensive investigations into birth in America. These statistics and the cultural worldview they represent have been a driving force behind Kindred World’s nonprofit work to educate and support the public for over a quarter century. Learn more about our nonprofit vision for restoring baselines for human wellbeing here. Please support our nonprofit work here.

 

Homicide leading cause of death for pregnant women in U.S..Harvard School of Public Health. October 2022. Women in the U.S. who are pregnant or who have recently given birth are more likely to be murdered than to die from obstetric causes—and these homicides are linked to a deadly mix of intimate partner violence and firearms, according to researchers from Harvard T.H. Chan School of Public Health.

New National Study Finds Homicide and Suicide is the #1 Cause of Maternal Death in the U.S. Society for Maternal Fetal Medicine. January 2025.

Lost Mothers: Maternal Care and Preventable Deaths

Key Findings From ProPublica’s Investigation

• Rising Death Rates: While other wealthy nations saw steady declines in maternal mortality, the U.S. stood out as the only developed nation where the rate of women dying from pregnancy complications actually increased. [1]
• Severe Complications: For every woman who dies during or shortly after childbirth, more than 100 women experience severe maternal morbidity—amounting to roughly 65,000 near-misses annually from issues like hemorrhage, sepsis, and organ failure. [1, 2]
• Extreme Racial Disparities: The data exposed a systemic crisis for minority families; Black mothers are over 240% more likely to die from pregnancy-related causes than white mothers, a gap that persists regardless of income or education levels. [1]
• Postpartum Danger Zone: More than half of all maternal deaths occur after the baby is born, sometimes six or more weeks postpartum, fueled by a fragmented healthcare system and gaps in health insurance. [1]

Why the U.S. Outpaces Other Wealthy Countries

The Lost Mothers Project identified several systemic reasons why the U.S. healthcare model fails expectant mothers: [1, 2]

1. Newborn-Centric Focus: Hospital protocols and the medical infrastructure heavily prioritize the health and stabilization of the infant while often overlooking or dismissing the critical warning signs of the mother. [1]
2. Inconsistent Medical Protocols: The U.S. lacks unified federal mandates for handling obstetric emergencies. Individual hospitals utilize a hodgepodge of safety rules, allowing treatable complications like high blood pressure and hemorrhages to become fatal. [1, 2]
3. Maternity Care Deserts: A critical shortage of rural hospitals, midwives, and specialized providers forces many pregnant individuals to travel long distances without adequate prenatal or postpartum tracking. [1]
4. Funding Inequities: ProPublica revealed that only about 6% of federal block grants for “maternal and child health” actually go toward the mother’s health, with the remaining balance allocated exclusively to infant care. [1]

 

Deadly Deliveries: A USA TODAY Investigation. USA Today. Updated March 22, 2021.

More than 50,000 women are severely injured during childbirth each year in the United States. About 700 mothers die. USA TODAY investigates why the U.S. is the most dangerous place to give birth in the developed world.

Part 1: Hospitals know how to protect mothers. They just aren’t doing it.

• How hospitals are failing moms, told in graphics 
• ‘I am one of the 50,000.’ These women want you to hear their stories
• High blood pressure shouldn’t be fatal, but for this new mom it was

Part 2: What states aren’t doing to save new mothers’ lives 

Part 3: Hospitals blame moms when childbirth goes wrong. Secret data suggests it’s not that simple.

• Why we’re revealing secret childbirth complication rates 
• Childbirth complication rates at maternity hospitals 
• Episiotomies are risky, yet dozens of hospitals are doing too many

 

The New U.S. Maternal Mortality Rate Fails to Capture Many Deaths. Since 2007, the government had held off on releasing an official estimate of expectant and new mothers who died from causes related to pregnancy and childbirth. It waited for the data to get better. But the new, long-anticipated number falls short.

U.S. “most dangerous” place to give birth in developed world, USA Today investigation finds. CBS News, July 26, 2018. A USA Today investigation finds the United States is the “most dangerous place to give birth in the developed world.” Every year in the U.S., more than 50,000 mothers are severely injured during or after childbirth and 700 die. USA Today’s investigation, “Deadly Deliveries,” claims women are dying and suffering life-altering injuries during childbirth because hospitals are not following long-known safety measures.

The Continued Mistreatment of Women During Pregnancy and Childbirth. October 2019. National Institutes of Health. Mistreatment of women during pregnancy and childbirth continues to define our American way of birth in spite of decades of awareness and concern. The Giving Voice to Mothers study identifies the incidence of mistreatment of childbearing women in the United States, the factors that increase a woman’s risk of being mistreated including socio economic and racial characteristics, place of birth, and health-care provider. This editorial highlights the study findings, the role of the current maternity care system in perpetuating inequality and mistreatment, and calls on all stakeholders to create a culture that cares for women with respect and dignity. The editor also describes the contents of this issue, which offer a broad range of resources, research, and inspiration for childbirth educators in their efforts to promote, support, and protect natural, safe, and healthy birth.

One in 5 Women Reported Mistreatment While Receiving Maternity Care. Survey finds clear disparities by race/ethnicity and insurance types. August 2023. Centers for Disease Control, CDC Newsroom.

Deadly Delivery: The Maternal Health Care Crisis in the USA. Amnesty International. 2010. On March 12, 2010, Amnesty International issued a report entitled Deadly Delivery: The Maternal Health Care Crisis in the USA, which documented that although the United States spends more on health care than any other country, it ranked 41st (at the time of publication) in terms of mater- nal death. As the report demonstrated, this is not just a matter of public health, but a human rights issue. Half of these deaths are preventable, and the report clearly demonstrated many barriers women face in accessing high quality maternal care.

 

State of Birth in the World

Mistreatment and violence against women during reproductive health care and facility-based child birth is a serious violation of women’s human rights which occurs across all geographical and income-level settings¹. In a statement published in 2014, the World Health Organization reported that disrespectful and abusive treatment occurs during childbirth in facilities and includes “outright physical abuse, profound humiliation and verbal abuse, coercive or unconsented medical procedures (including sterilization), lack of confidentiality, failure to get fully informed consent, refusal to give pain medication, gross violations of privacy, refusal of admission to health facilities, neglecting women during childbirth to suffer life-threatening, avoidable complications, and detention of women and their newborns in facilities after childbirth due to an inability to pay.”²

International human rights bodies and experts have addressed some of the types of mistreatment and violence, however, they have focused on a limited number of issues and their analysis of those issues has largely failed to take into account the broader context in which mistreatment and violence occur.

A human rights-based approach to mistreatment and violence against women in reproductive health services with a focus on childbirth and obstetric violence. July 2019. A United Nations General Assembly Report.

Obstetric Violence Is Gender-Based Violence. It’s Time the Law Recognized It. Obstetric violence is the physical and emotional abuse of pregnant people seeking sexual and reproductive health services and information, including maternal health care — like antenatal care, intrapartum care, post-natal care, gynecological examinations, abortion and post-abortion care, fertility treatments, and contraception. It includes abusive treatment by medical practitioners, nurses, midwives, and other hospital staff, including administrative staff and security personnel.

 

KINDRED RECOMMENDED BIRTH RESOURCES

 

Kindred’s New Story Videos on Birth Psychology on YouTube and Vimeo.

Discover BIRTH as one of nine components of our Evolved Nest in the Virtual Learning Center.

Kindred’s BookShop collection of books on Prenatal and Perinatal Psychology.

 

Organizations that can help you prepare for a health birth in an unhealthy birth system:

 

Anti-Depressants In Pregnancy: Risks to the Fetus and Long-term Health of the Child. A Resource and Science page. The research literature reveals that antidepressant use in pregnancy poses considerable risks to the fetus and the long-term health of the child. These risks include preterm birth, birth defects, abnormal brain development, and behavioral abnormalities in early childhood.

Association for Prenatal and Perinatal Psychology and Health. APPPAH illuminates the life-long impact of conception, pregnancy and birth on babies, families and society. APPPAH’s mission is to educate professionals and the public about, and advocate for, the life-changing discoveries made in the area of prenatal and perinatal psychology and health.

Baby-Friendly Hospital Initiative.  The Baby-Friendly Hospital Initiative (BFHI) is a global program that was launched by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) in 1991 to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding and mother/baby bonding. It recognizes and awards birthing facilities who successfully implement the Ten Steps to Successful Breastfeeding (i) and the International Code of Marketing of Breast-milk Substitutes (ii). The BFHI assists hospitals in giving all mothers the information, confidence, and skills necessary to successfully initiate and continue breastfeeding their babies or feeding formula safely, and gives special recognition to hospitals that have done so.

Birthing the Future. The mission of Birthing The Future®, is to gather, synthesize, and disseminate the finest world wisdom about birthing and the care of mothers and babies from pre-conception to the first birthday.

Black Mamas Matter is a Black women-led cross-sectoral alliance. We center Black mamas to advocate, drive research, build power, and shift culture for Black maternal health, rights, and justice.

We envision a world where Black mamas have the rights, respect, and resources to thrive before, during, and after pregnancy.

The Bradley Method of Natural Childbirth. The Bradley Method® teaches natural childbirth and views birth as a natural process. It is our belief that most women with proper education, preparation, and the help of a loving and supportive coach can be taught to give birth naturally.

CAPPA, Childbirth and Postpartum Professional Association.  For over a decade, CAPPA’s mission has been to offer comprehensive, evidence-based education, certification, professional membership and training to childbirth educators, lactation educators, labor doulas, antepartum doulas and postpartum doulas worldwide. CAPPA is proud to provide new and expectant families access to these professionals here.

Cesarean Statistics for Your Local Hospital.  Find C-section and VBAC, vaginal birth after Cesarean, rates for your local hospital.

Citizens for Midwifery. The goal of Citizens for Midwifery is to see that the Midwives Model of Care is available to all childbearing women and universally recognized as the best kind of care for pregnancy and birth. Citizens for Midwifery also endorses the Mother-Friendly Childbirth Initiative™.

Coalition for Improving Maternity Services. The Coalition for Improving Maternity Services (CIMS) is a coalition of individuals and national organizations with concern for the care and well-being of mothers, babies, and families. Our mission is to promote a wellness model of maternity care that will improve birth outcomes and substantially reduce costs. This evidence-based mother-, baby-, and family-friendly model focuses on prevention and wellness as the alternatives to high-cost screening, diagnosis, and treatment programs.

Doulas of North America. Pardon us for bragging, but we are the oldest, largest and most respected doula association in the world. Our founders are among the foremost experts on doula care, and DONA International certification is a widely respected measure of quality and professionalism. We are an international, non-profit organization of doulas that strives to have every doula trained / educated to provide the highest quality / standards for birth and/or postpartum support to birthing women and their families.

International Cesarean Awareness Network. The International Cesarean Awareness Network, Inc (ICAN) was formed over 25 years ago in order to support women in their journey towards understanding the risks of cesarean section and with the purpose of helping them have healthy births and healthy lives after undergoing the surgery that changed them.

International Cesarean Awareness Network & VBAC Information. This is a collection of fact sheets and information put out by the International Cesarean Awareness Network (ICAN) and other sources. Information includes how to prevent an unnecessary cesarean, Vaginal birth after cesarean (VBAC), how to find resources in your community, information about ICAN, and how to become a part of ICAN.

International Childbirth Education Association. ICEA is an organization of over 4,000 members from throughout the United States and 42 countries who believe in freedom of choice based on knowledge of alternatives in family-centered maternity and newborn care.

International Confederation of Midwives. ICM works closely with Midwives and Midwives Associations to secure women’s rights and access to midwifery care before, during and after childbirth. We work to improve maternal and newborn health and ensure that Midwives Associations have the tools necessary to be effective.

We also work in partnership with many other international organisations, to strengthen midwifery globally and achieve our objectives:

• To promote and strengthen the midwifery profession
• To promote the aims of the Confederation internationally
• To work to improve women’s health globally

Midwives and Mothers in Action, MAMA, The MAMA campaign is a collaborative effort by the National Association of Certified Professional Midwives (NACPM), Midwives Alliance of North America (MANA), Citizens for Midwifery (CfM), International Center for Traditional Childbearing (ICTC), North American Registry of Midwives (NARM), and the Midwifery Education Accreditation Council (MEAC). This partnership is now at work to gain federal recognition of Certified Professional Midwives so that women and families will have increased access to quality, affordable maternity care in the settings of their choice.

Midwives Alliance of North America, MANA, In 1982, the Midwives Alliance of North America (MANA) was established as a professional organization for all midwives, recognizing the diversity of educational backgrounds and practice styles within the profession. Its goal is to unify and strengthen the profession of midwifery, thereby improving the quality of health care for women, babies, and communities.

National Association of Certified Professional Midwives.  

North American Registry of Midwives.  

Midwifery Today. Well-written technical articles by doctors, midwives, doulas, childbirth educators, nutritionists, herbalists and other practitioners. Birth stories that are beautifully written and have something to teach the practitioner. Stories about midwifery practices in other countries. Well-written academic articles on the subject of midwifery by experts.

Postpartum Support International, PSI. Postpartum Support International (PSI) was founded in 1987 by Jane Honikman in Santa Barbara, California. The purpose of the organization is to increase awareness among public and professional communities about the emotional changes that women experience during pregnancy and postpartum. Approximately 15% of all women will experience postpartum depression following the birth of a child. Up to 10% will experience depression or anxiety during pregnancy. When the mental health of the mother is compromised, it affects the entire family.

The Unnecesarean is a patient advocacy Web site that pulls back the curtain on the practice of prophylactic cesarean surgery for suspected fetal macrosomia and illuminates the experiences of women who have been harmed by the aggressive practice of defensive medicine. The site provides information about preventing an unnecessary cesarean and resources for making fully-informed decisions about childbirth while offering an irreverent take on the maternity care crisis in the United States and beyond. The most recently released data from the CDC on childbirth showed that 32.9 percent of U.S. babies in 2008 were born by surgery.  This is the twelfth year in a row that the rate has risen.  Rates of severe maternal morbidity have increased, yet maternal and infant mortality have not seen a decline with the aggressive use of this life saving surgery.

VBAC.com. VBAC (vaginal birth after cesarean) is a safe alternative to a routine repeat cesarean. Our aim is to provide evidence-based  resources and support about VBAC  from a variety of sources; scientific studies, professional guidelines, government reports, birth advocacy groups, as well as successful and established VBAC programs. Our goal is to help women make informed decisions about how they want to give birth and to encourage an honest and respectful dialogue with their caregivers.