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New mortality statistics published in JAMA Network Open reveal that health plans may need to recalibrate their maternal health risk management programs based on substantially revised comparative data. The January 2026 study looking at data from 2018 to 2021 found that the number of deaths related to pregnancy was 44 to 70 times higher than those related to abortion, which is at least three times more than the 14.7 ratio used for clinical and coverage decisions since 200
Lead researcher Maria Steenland and colleagues at the University of Maryland examined 14.9 million births and 3.7 million abortions, finding pregnancy-related mortality rates of 20.6 to 32.3 deaths per 100,000 births compared to 0.464 abortion-related deaths per 100,000 procedures. The dramatic shift stems primarily from improved maternal death detection following the implementation of pregnancy checkboxes on death certificates across all states in 2018, which identified previously unreported deaths that affected quality metrics and risk stratification models.
The findings carry particular significance for managed care organizations tracking maternal mortality as a core quality measure. Health plans rely on accurate baseline data for care management protocols, high-risk pregnancy identification, and resource allocation decisions. The new ratios show that current risk assessment tools may not accurately measure the risk of pregnancy-related death. This could have an effect on actuarial assumptions and investments in care coordination.
Data collection challenges complicate future surveillance efforts. Three states with abortion restrictions have delayed or disbanded Maternal Mortality Review Committees since 2022, while recent federal workforce reductions eliminated two-thirds of the CDC's Division of Reproductive Health staff. These changes may limit the granular state-level data managed care organizations use for regional network adequacy planning and targeted quality improvement initiatives. The study period ended in 2021 as the most recent year the CDC released abortion surveillance data, leaving health plans without updated metrics for post-2021 program evaluation.
