The Virginia Maternal Mortality Review Team (MMRT) is proud to present the 2025 Annual Report of statistical data as mandated by Code of Virginia, § 32.1-283.8. This shall be made available to the Governor and the General Assembly by October 1, 2025. This report provides an overview of the patterns and trends in pregnancy-associated deaths in the state of Virginia in 2023. Pregnancy-associated death is defined as “the death of a woman while pregnant or within one year of pregnancy regardless of the outcome of the pregnancy or the cause of death(*1).

This report also presents the final MMRT determinations of preventability, pregnancy-relatedness, and contributors to mortality for 2021 pregnancy-associated death cases. Additionally, final recommendations from the MMRT for the prevention of future pregnancy-associated deaths based on the final 2021 data are also included. The MMRT is dedicated to understanding the circumstances surrounding each of these deaths so that strategies can be developed to reduce maternal mortality across the Commonwealth. The MMRT is an ongoing collaborative effort led by the VDH’s Office of Family Health Services and Office of the Chief Medical Examiner. Data highlights are listed below.

2023 DATA HIGHLIGHTS

1. In the Commonwealth of Virginia, the number of pregnancy-associated deaths decreased from 67 in 2022 to 45 in 2023.

2. The pregnancy-related death rate decreased from 70.1 per 100,000 live births in 2022 to 48.6 per 100,000 live births in 2023.

3. Approximately 42% of these deaths occurred between 43 and 365 days after the end of the pregnancy.

4. Over 45% of pregnancy-related deaths involved women ages 35 and older.

a. Pregnancies in women over the age of 35 are considered high-risk and account for over 24% of all live births in 2023.

5. Black women continue to experience higher rates of pregnancy-associated deaths when compared to their White counterparts (70.7 vs. 36.2, respectively).

6. Black women were more likely to die from cardiac related causes (16.3 vs. 6.0 per 100,000 live births, respectively).

7. All of the pregnancy-associated accidental deaths resulted from accidental overdoses. Eighty-five percent of these deaths occurred due to the combined use of illicit and prescription drugs.

8. The pregnancy-associated death rate from accidental overdoses was higher among Black and Other race women when compared to White women (21.7 and 25.1 vs. 10.6, respectively).

9. The Southwestern Health Services Area had the highest rate of pregnancy-associated deaths at 99.4 per 100,000 live births, followed by the Central (75.3 per 100,000 live births) and Eastern (61.9 per 100,000 live births) Health Services Areas.

10. Over 43% of pregnancy-associated deaths in 2021 were determined to be pregnancy-related2 by the Maternal Mortality Review Team.
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(*1) Association for Maternal and Child Health Programs. (2022, August 8). Definitions. Retrieved from Review to Action: https://reviewtoaction.org/learn/definitions