it gets worse

More American women over 40 are having babies. Their risk of dying from it keeps rising too

Black women above 40 especially experience a mortality rate of more than 300 per 100,000 live births

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A pin reads Black Mamas Matter
Photo: Leah Millis (Reuters)

Giving birth in the US has long been a dangerous affair.

In 2021, on average, 32.8 women died of pregnancy-related causes for every 100,000 live births, according to newly released data from the Centers for Disease Control and Prevention (CDC). That is almost 11 times the rate of Greece, Poland, or Iceland, the countries with the lowest maternal mortality rates, and close to three times the European average. For Black women in the US, the rate is much higher, at 69.9 per 100,000 live births.

But the numbers show shocking risk for US women 40 and above. The number of births among that age group has gone up through the years, but the mortality has increased even more. As of 2021, the overall maternal mortality rate for women in their 40s was 138.5 per 100,000.


For US Black women, it was 300.8 per 100,000 live births. By way of comparison, this is more than the overall mortality rate in Sudan and many other low-income African countries.


More children after 40, and higher mortality

Later pregnancies typically carry higher risk, though mortality rates don’t always increase linearly with age. Even when they do, in countries comparable to the US, the rates are much smaller.


In the UK, maternal mortality for women 40 and over was 25.8 on average (pdf, p. 13) between 2018 and 2020. In Italy, the latest reported rate (2016; pdf, p. 28) was 27.5 per 100,00 live births. In France, where the relative risk is four times higher than average for women 40 and above, the rate was around 33 per 100,000 live births (pdf, p. 4) as of 2015. Though not all comparison data is as recent as the US, it is worth noting the magnitude of the distance. Further, despite the backward progress in the US, maternal mortality is an indicator that tends to improve over time.


The trend is alarming, not least because the growing number of women giving birth at 40 or above. Though in the US the age of pregnancy tends to be lower than other countries. In France and the UK, 5% or more of pregnancies occur at 40 or over, in Spain almost 9% do, and in Italy 10%. In the US, it’s 3.7% as of 2021, up from 3.3% in 2018.