Examining maternal mortality in Mississippi
By Michelle Owens, MD, MS, FACOG and C. LaToya Mason, MD, FASA
JA Guest Writers
In Mississippi, where maternal mortality rates remain among the highest in the nation, February’s designation as American Heart Month carries particular urgency. Heart disease is the leading cause of death in the United States, and its role in maternal health and maternal mortality is too often overlooked. Yet cardiovascular conditions are a leading cause of pregnancy-related deaths and severe maternal complications, making this a critical public health issue for families and communities across our state.
In this commentary, the physician authors join the Jackson Advocate, the American Heart Association, and others nationwide in calling attention to the vital connection between maternal health and maternal mortality. Maternal mortality is not only a devastating loss for families, but also a powerful indicator of how effectively healthcare systems support women before, during, and after pregnancy. While this commentary is not a comprehensive review of this complex issue, it highlights the state of maternal health in Mississippi by sharing recent data, examining the drivers of persistent disparities, and spotlighting the work of local health leaders who are committed to preventing maternal deaths and improving outcomes for mothers in our state and beyond.
When examining maternal mortality in Mississippi, it becomes clear that our state mirrors troubling national trends. Over the past two to three decades, rates of maternal mortality and severe maternal morbidity have risen steadily across the United States, which now has the highest maternal mortality rate among other highly developed nations. Cardiovascular disease has been a major driver of this increase. Between 1999 and 2022, cardiovascular-related causes of maternal death more than doubled nationwide.
In real terms, an estimated 600 women in the United States died from cardiovascular complications related to pregnancy, including pregnancy-related heart failure (peripartum cardiomyopathy), heart attacks (myocardial infarction), and high blood pressure (hypertensive) disorders. The burden is especially severe in Mississippi. In 2021, the state’s maternal mortality rate was 79.6 deaths per 100,000 births, which is more than double the national rate of 32.9 deaths per 100,000 births.
A closer look at these statistics also reveal stark racial and ethnic disparities. Both nationally and in Mississippi, non-Hispanic Black women and American Indian women face a risk of maternal death that is three to four times higher than that of their white counterparts. Contributing factors include a higher prevalence of underlying health conditions, limited access to quality healthcare, and persistent mistrust of healthcare systems, particularly among African American communities. Together, these social and structural barriers continue to fuel inequities in maternal outcomes and underscore the urgent need for action.
Across Mississippi, health professionals, advocates, and community partners are working together to improve maternal health and eliminate preventable maternal deaths. Central to this effort is the Mississippi Maternal Mortality Review Committee (MMRC), which conducts detailed reviews of maternal deaths to understand why they occur and how they can be prevented. Using a standardized review process developed by the Centers for Disease Control and Prevention, the committee identifies contributing factors, assesses preventability, and develops recommendations to improve care.
These efforts are especially critical given the broader impact of cardiovascular disease on women’s health. Cardiovascular disease is the number one cause of death for women overall, yet Black women carry the heaviest burden. An estimated 59 percent of Black women ages 20 and older are living with some form of cardiovascular disease. This reality underscores why heart health is not only a long-term concern, but also a maternal health issue, and why empowering Black women with information and tools to protect their health is essential.
Mississippi’s most recent Maternal Mortality Report, covering the years 2019 through 2023, highlights both the urgency of this work and the opportunity for change. During that period, the state’s maternal mortality rate was 32.9 deaths per 100,000 births, compared with a national rate of 19.8 deaths per 100,000 births. Hypertensive disorders of pregnancy and infections were the leading causes of pregnancy-related deaths overall. Among Black women, hypertensive disorders and other cardiovascular conditions were the leading causes of pregnancy-related death. Notably, more than 82 percent of these deaths were deemed preventable.
In response, the Mississippi MMRC has issued targeted recommendations focused on education and awareness, support for high-risk mothers, improved access to care, community and environmental health, and healthcare system standardization. These recommendations are shared with hospitals, state health agencies, perinatal collaboratives, and community organizations to improve quality of care and outcomes. At every stage, equity must remain foundational. Providing culturally competent care that respects patients’ beliefs, values, and lived experiences is essential to closing gaps in maternal health.
State and national partnerships are critical to sustaining progress and the work is on-going. Maternal health affects every community, and cardiovascular health is a key part of that equation. By ensuring that women, especially Black women, have access to accurate information, quality care, and supportive systems, Mississippi can reduce disparities, save lives, and move closer to eradicating preventable maternal mortality in our state and beyond.
