The United States has had the highest maternal mortality rate among income-comparable countries for years — and this remains the case.

While campaigning for president in 2020, Joe Biden said he would "reduce our unacceptably high maternal mortality rate."

In 2022, the latest year with available data, 817 women in the U.S. died of maternal causes; a rate of 22.3 maternal deaths per 100,000 live births, according to the Centers for Disease Control and Prevention's National Center for Health Statistics. This compares with 1,205 maternal deaths in 2021 — a year with a spike in deaths primarily because of the COVID-19 pandemic — and 861 in 2020, 754 in 2019 and 658 in 2018.

We don't yet have data for Biden's last two years in office. And although 2022's rate is about the same as when Biden made his promise in 2020, maternal health experts said his administration worked to improve maternal care. 

The American Rescue Plan Act, which Biden signed into law in 2021, included a provision for states to extend Medicaid postpartum coverage to 12 months until May 2023. The 2022 Consolidated Appropriations Act that Biden signed in 2023 gave states the option to make the expansion permanent. Today, 43 states have Medicaid coverage until 12 months postpartum.

Maternal health experts said the administration's push to extend this coverage has been critical to making good on Biden's promise. Historically, the Medicaid program set the minimum eligibility for this coverage at 60 days after giving birth, though 53% of maternal deaths happen a week to a year after pregnancy.

Because the expansion is still relatively new, it's not yet possible to measure whether it has reduced postpartum hospitalizations and improved maternal mortality rates, experts said. But some preliminary studies have linked a reduction in postpartum hospitalizations to the Medicaid expansions.

In June 2022, Biden's administration also unveiled the White House Blueprint for Addressing the Maternal Health Crisis. The document included policy proposals such as the Medicaid postpartum expansion, and called for conducting more maternal health research and making investments into programs and training to address geographic, racial and ethnic disparities in maternal care.

In August, the U.S. Department of Health and Human Services announced $558 million in funding to improve maternal health. This includes $440 million to expand voluntary home visiting programs to improve maternal and child health and $118.5 million to improve public health infrastructure to better identify and prevent pregnancy-related deaths.

And in November, the Department of Health and Human Services, through the Centers for Medicare and Medicaid Services, announced new health and safety requirements for hospitals and "Critical Access Hospitals," a designation given to eligible rural hospitals, providing obstetrical services to make pregnancy, childbirth and postpartum care safer. The Centers for Medicare and Medicaid Services also said it was removing barriers to expand access to care for those formerly incarcerated and others in underserved communities.

The policies are included in the 2025 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center final rule.

"CMS is committed to addressing our nation's maternity care crisis. Today, we are establishing the first-ever maternal health and safety standards for hospitals," Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure said in a Nov. 1 news release. The final rule also "expands access to behavioral health services, Brooks-LaSure said.

Overall, maternal health experts said the U.S. hasn't seen a meaningful reduction in the maternal mortality rate. But they noted that the administration's focus on expanding postpartum health coverage and advancing training and data collection are significant steps toward making good on Biden's pledge. We rate this Compromise. 

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In 2020, U.S. maternal mortality reached a strikingly high rate, disproportionately affecting people of color and hitting tallies more than double those of other developed countries. These numbers, and related issues of maternal health, became talking points for then-candidate Joe Biden during his 2020 presidential campaign, when he promised to "reduce our unacceptably high maternal mortality rate."

We decided to check the progress on this promise about two years into his presidency.

In general, maternal health experts told us that the administration's focus on advocacy, expanding health coverage, and advancing data collection are significant steps toward making good on his pledge.

"The current administration is supporting and advancing maternal health in a completely unprecedented, comprehensive way," said Carol Sakala, the National Partnership for Women & Families' director for maternal health.

The key piece of evidence experts pointed to is the White House Blueprint for Addressing the Maternal Health Crisis. The document, unveiled by the Biden administration in June, included policy proposals such as expanding Medicaid's required postpartum coverage to at least 12 months and conducting more maternal health research. It also advanced new initiatives to diversify the workforce involved in treating patients while they are pregnant and after they give birth, and investments to address geographic, racial, and ethnic disparities in care.

The administration's push for Congress and the states to extend Medicaid's postpartum coverage to 12 months — with either the passage of federal legislation or the approval of state Medicaid waivers, or both — is critical to making good on this promise, experts said.

Historically, the Medicaid program sets the minimum eligibility for this coverage at 60 days after giving birth, though 53% of maternal deaths happen a week to a year after pregnancy, according to the Centers for Disease Control and Prevention.

The American Rescue Plan Act, which Biden signed into law in 2021, included a provision giving states the option to extend Medicaid postpartum coverage to 12 months. That provision was scheduled to expire in five years, but the option was then made permanent — though the coverage change was not mandated — in the 2022 year-end omnibus bill.

Experts also said the administration's goal of providing more comprehensive Medicaid coverage for all stages of pre- and postnatal care, and postpartum services would help address racial and ethnic disparities.

"It's the emphasis that it takes a team," said Dr. Gloria Bachmann, OB-GYN clinical leader at the American Medical Women's Association and a professor of OB-GYN at Rutgers Robert Wood Johnson Medical School.

But none of the Biden administration efforts are fast fixes, especially when it comes to stepping up research and data collection — which have significant roles in improving the nation's maternal health infrastructure.

"It's really something to get started for the long haul," said Dr. Theresa Rohr-Kirchgraber, president of the American Medical Women's Association.

We rate this promise In the Works.