Maternal, Child & Adolescent Health Division
CA-PMSS Factsheet
Pregnancyā-Related Mortality ā 2019ā2021
The
California Pregnancy Mortality Surveillance System (CA-PMSS) provides the most accurate information on Californiaās pregnancy-related mortality ā a key measure of population health. CA-PMSS defines pregnancy-related deaths as deaths during pregnancy or within one year of the end of pregnancy from causes directly related to or worsened by pregnancy or its management, excluding accidental or incidental causes (suicide, homicide, drug overdose, or other injury). In 2019ā2021, California had 1.28 million births and 226 pregnancy-related deaths.
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By the Numbers
Pregnancy-Related Mortality in 2021
Californiaās rate of pregnancy-related deaths increased in 2020 during the COVID-19 pandemic:
- 1.2 times higher than the rate of 18.6 deaths per 100,000 live births in 2020
- 1.7 times higher than the rate of 12.8 deaths per 100,000 live births in 2019
In 2019-2021, about 1 in 4 pregnancy-related deaths was due to COVID-19.
Leading Causes in 2019-2021
The leading causes of pregnancy-related mortality were COVID-19, cardiovascular disease (CVD), hemorrhage (HEM), thrombotic pulmonary embolism (TPE), other infection (INF), amniotic fluid embolism (AFE), and hypertensive disorders of pregnancy (HDP).
Changing Trends in Causes
California's rate of pregnancy-related deaths from infection increased significantly, largely due to the rise in deaths from COVID-19.
The rate was 5.5 deaths per 100,000 live births in 2019ā2021:
- 2.8 times higher than the rate of 2.0 deaths per 100,000 live births in 2016ā2018 (before the COVID-19 pandemic)
The rates for other causes of pregnancy-related mortality remained relatively stable.
Disparities by Race/Ethnicity
Trends in 2018ā2020
Racial and ethnic disparities in the rate of pregnancy-related deaths decreased in 2019ā2021 but persist. The rate for Black birthing people was 49.7 deaths per 100,000 live births in 2019ā2021:
- 2.8 to 3.6 times higher than the rates for White (14.0), Asian (14.4), and Hispanic/Latino birthing people (17.7)
In 2016ā2018, the rate of pregnancy-related deaths was 3.4 to 4.3 times higher for Black birthing people.
Disparities by Health Insurance
Medi-Cal & Trends in 2019-2021
The disparity in the rates of pregnancy-related deaths for birthing people with Medi-Cal health coverage and those with private health insurance remained wide in 2019ā2021.
The rate for birthing people with Medi-Cal health coverage was 26.0 deaths per 100,000 live births in 2019ā2021:
- 2.7 times higher than the rate of 9.6 deaths per 100,000 live births for birthing people with private insurance
In 2016ā2018, the rate of pregnancy-related deaths was 1.6 times higher for birthing people with Medi-Cal health coverage.
Disparities by Community Conditions
Social Determinants & Trends in 2018-2020
The disparity in the rates of pregnancy-related deaths for birthing people living in the least healthy communities* and those living in the healthiest communities widened in 2019ā2021.
The rate for those living in the least healthy communities was 27.3 deaths per 100,000 live births in 2019ā2021:
- 3.7 times higher than the rate of 7.4 deaths per 100,000 live births for those living in the healthiest communities
In 2016ā2018, the rate of pregnancy-related deaths was 1.7 times higher for birthing people living in the least healthy communities.
*Community conditions were measured using the Healthy Places Index
www.healthyplacesindex.orgāāāāāāāāāāāāāāāā
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Page Last Updated : March 14, 2025