US maternal mortality rate nearly triples as delivery costs rise sixfold
A study released by the Birth Injury Lawyers Group reports that childbirth costs in the United States have risen sharply since the 1980s even as recorded maternal mortality nearly tripled. The analysis compiles employer health-plan claims, CDC figures, and NCHS statistics to compare prices and outcomes across four decades. Vaginal deliveries and cesarean sections both cost several times more today than in 1986, while the share of births involving surgery nearly doubled.
Vaginal delivery charges increased from $2,560 in 1986 to $15,712 in 2021-2023, roughly six times higher according to employer health-plan claims data. Cesarean delivery charges rose from $4,270 to $28,998 over the same span, nearly seven times the earlier figure. These multipliers come directly from the compiled claims records cited in the study.
Cesarean births accounted for 16.5 percent of all U.S. deliveries in 1980 and reached 32.4 percent in 2024, a 96 percent increase reported by NCHS. At the same time, recorded maternal mortality climbed from 7.9 deaths per 100,000 live births in the 1980s to 23.1 deaths per 100,000 live births in the 2020s, an approximately threefold rise based on CDC and NCHS vital statistics.
Hospital data from 2003 showed an average childbirth charge of $8,300, with vaginal deliveries at $6,200 and cesareans at $11,500. Adjusted to 2024 dollars those amounts equal $14,151, $10,570, and $19,606 respectively. By comparison, inflation-adjusted 1986 benchmarks stood at $7,327 for vaginal delivery and $12,222 for cesarean, less than half the recent employer-claims averages.
Average out-of-pocket spending now totals $2,743 for pregnancy and childbirth care, exceeding the entire nominal cost of a 1986 delivery. Real cost growth beyond inflation appears in the gap between the $7,327 inflation-adjusted 1986 vaginal price and the current $15,712 figure, more than double the earlier benchmark after accounting for general price changes.
Medicaid financed 40.2 percent of U.S. births, or 1,445,210 deliveries, in 2024 while private insurance covered 51.8 percent and self-pay reached up to 4.7 percent. Privately insured mothers recorded a cesarean rate of 33.5 percent compared with 31.9 percent for Medicaid-covered births. Babies born under Medicaid were 37 percent more likely to have low birthweight and 41 percent more likely to have very low birthweight than those covered by private insurance across 7.4 million Medicaid and 9.2 million privately insured births from 2020 to 2024.
State-level data reveal a 0.67 correlation between Medicaid birth share and low-birthweight rates and a 0.5 correlation with infant mortality. The ten states with the highest Medicaid reliance averaged 9.5 percent low birthweight and 6.38 infant deaths per 1,000 live births. The ten states with the lowest Medicaid reliance averaged 7.45 percent low birthweight and 4.75 infant deaths per 1,000 live births.
Death-certificate changes between 2003 and 2017 improved identification of pregnancy-related deaths, so older and newer maternal mortality figures are not perfectly comparable. Even with that reporting shift, costs have risen substantially while maternal health measures have remained stagnant or worsened, according to the Birth Injury Lawyers Group compilation of the underlying CDC and NCHS records.
