Counties Leading the Charge Against Maternal Mortality

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According to The Center for Disease Control and Prevention (CDC) maternal mortality, or a pregnancy-related death, is a death “that occurs up to one year after a woman gives birth.” As it stands, the United States is the only developing county with rising rates of maternal death, with an increase from 13.3 to 22 maternal deaths per 100,000 live births between 2006 and 2013. While the risk of maternal death impacts ethnic and racial groups nationwide, the burden is disproportionally felt among African American and Indian/Alaskan Native women. Per the CDC, non-Hispanic Black women and American Indian/Alaska Native women experience maternal death at 3 to 4 times the rate of non-Hispanic white women. Additionally, the CDC notes that regardless of race or ethnicity, around 60% of maternal deaths cases in the United States could be prevented with increased access and improved medical intervention. To combat this reality, counties have continued to lead the way in addressing pregnancy-related deaths.

Counties across the nation are working towards improving maternal health outcomes. As a state, California was able to reduce its maternal mortality rate by 55% between 2006 and 2013, which translates to a drop from 16.9 to 7.3 maternal deaths per 100,000 live births. While the effort to address maternal deaths was coordinated by the state Department of Public Health, much of the work was conducted at the county level given counties’ integral role in the management of hospitals and provision of health services. To expand access to quality health services for all women of childbearing age, adolescents, children and infants, the Sacramento County Public Health Department broadly offers Maternal, Child, and Adolescent Health Programs to its residents. Additionally, Sacramento County has gone beyond looking at just maternal mortality and have focused their efforts on addressing child deaths in African Americans through their Black Child Legacy Campaign. Other counties, such as Flagler County and Volusia County in Florida, have developed cross-county and regional partnerships in tackling the issue. The two Florida counties created The Healthy Start Coalition which aims to provide local support and resources to meet the needs of expecting mothers, infants, toddlers and their families.

In combating maternal mortality nationwide, it is important to recognize that leaders at all levels need to be engaged and mobilized to create sustainable solutions. Counties are key stakeholders and practitioners in this space and have been leading the charge in tackling this issue. While is no one size fits all solution, we are encouraged by the impact of counties’ innovative approaches and strategies.  To share any ideas or solutions you may have, please email 

About Kirsty Fontaine (Full Bio)

Program Manager – Health

Kirsty Fontaine is a Health Program Manager at the National Association of Counties (NACo). In this role, she manages projects that provide education and technical assistance to county officials, working to promote a culture of health in counties across the country.

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