Maternal Health and Wellbeing in the United States and Across the Globe

As of May 11, three days before Mother’s Day 2023, the public health emergency of COVID-19 will have ended. As Chicago, the United States, and the world experience low rates of illness and transmission, conversations have moved from masking to situational masking, with both local and federal transition plans to help guide parents.

This year, FCHIP focuses on the health status of mothers in the United States and across the globe. This 2023 report looks at employment, reproductive health, equity, and efforts to improve wellbeing and outcomes in light of the transition to a post-COVID-19 world and what practical next steps to take to support mothers around the world.

Working Mothers

Although COVID-19’s status as a public health emergency was lifted, mothers are still dealing with the pandemic’s ramifications. During the COVID-19 recovery stage, 60% of mothers (.pdf)  were concerned about maintaining a work-life balance. While only 6% of marriages have wives acting as the primary income earner, the percent of marriages with wives contributing financially has grown over the past few decades.

With more people working from home since 2019, some studies investigated how much time people – including working mothers – could save without a commute. On average, remote workers in the United States saved 55 minutes each day while working from home. Eight percent of that saved time went toward caregiving, but that percent is greater for people with children. 

Reproductive Health

The Dobbs v. Jackson decision lets states have greater control over abortion’s legal status. States that established restrictions on abortion have lower proportions of obstetricians and certified nurse midwives than states where abortion is still accessible. Despite lower teen birth rates across the country year to year, states with stricter abortion policies still have significantly more births per 1,000 women for 15-to 19-year-olds.

Maternal Mortality

In the United States, maternal mortality increased from 23.8 in 2020 to 32.9 deaths per 100,000 live births in 2021, according to a 2023 CDC report. Non-Hispanic Black mothers had a rate of 69.9 deaths per 100,000 live births, over double that of non-Hispanic white mothers. The United States has a history of ranking as one of the worst places for maternal mortality out of Organisation for Economic Cooperation and Development (OECD) countries. In 2021, the U.S. rate was just short of Costa Rica’s 2020 rate. Costa Rica had the second-highest maternal mortality of any OECD country in 2020.

Maternal Equity

Providing sustainable reproductive and maternal health care begins with guaranteeing equitable and affordable health care access to birthing parents. The United States is experiencing a synergistic epidemic with maternal morbidity and mortality and mental health. Most of the common contributing factors related to maternal mortality are preventable. Mental health conditions were the leading underlying cause of maternal deaths between 2017 and 2019, with white and Hispanic women most likely to die from suicide or drug overdose, while cardiac problems were the leading cause of death for Black women. Addressing the maternal mortality and mental health crisis should involve supporting safe pregnancies and childbirth, and eliminating disparities and barriers that prevent safe outcomes for birthing parents.

Programs Enriching Maternal Health in the United States

• Single Parent Advocate: Connects single-parent households with practical educational, social and emotional resources
• Black Mamas Matter Alliance: Brings together Black-run maternal health and reproductive justice groups around the country
• HEAR HER Campaign: CDC-led initiative designed to inform about pregnancy-related warning signs

Global Motherhood

Looking at the world more broadly, reducing maternal mortality efforts focus on minimizing disparities, increasing equity, and improving wellbeing internationally. Targeted approaches have included goals to improve social status and education, the latter of which is related to increased use of prenatal care for pregnant women. Use of prenatal care is a primary factor linked to maternal mortality. Overall, access to health care before and during pregnancy is essential for improving the lives of women; however, access to reproductive care is often limited. As in the United States, most deaths during pregnancy and birth are preventable, and ensuring healthy moms is essential to the health of people across the globe.

Shining Beacons: Programs Enriching Maternal Health Around the World

• mothers2mothers: African program utilizing “Mentor Mothers,” local community health workers living with HIV to help improve the health of mothers and families
• Criança Feliz: Home visiting service expansion in Brazil involving weekly home visits to families beginning at birth and continuing through a child’s first thousand days
• Maternal Early Childhood Sustained Home-visiting (MECSH): Available in Australia, Korea, United Kingdom and the United States, MECSH is a sustained home visiting program that adapts to community and local systems needs
• Amna: A refugee-led program originating in Greece that provides mental health support to refugee families from Afghanistan and Ukraine using a play-based model