United States US: Maternal Mortality Ratio: Modeled Estimate: per 100,000 Live Births data was reported at 14.000 Ratio in 2015. This stayed constant from the previous number of 14.000 Ratio for 2014. United States US: Maternal Mortality Ratio: Modeled Estimate: per 100,000 Live Births data is updated yearly, averaging 13.000 Ratio from Dec 1990 (Median) to 2015, with 26 observations. The data reached an all-time high of 15.000 Ratio in 2009 and a record low of 11.000 Ratio in 1998. United States US: Maternal Mortality Ratio: Modeled Estimate: per 100,000 Live Births data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s USA – Table US.World Bank: Health Statistics. Maternal mortality ratio is the number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births. The data are estimated with a regression model using information on the proportion of maternal deaths among non-AIDS deaths in women ages 15-49, fertility, birth attendants, and GDP.; ; WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division. Trends in Maternal Mortality: 1990 to 2015. Geneva, World Health Organization, 2015; Weighted average; This indicator represents the risk associated with each pregnancy and is also a Sustainable Development Goal Indicator for monitoring maternal health.

Maternal mortality rates can vary significantly around the world. For example, in 2022, Estonia had a maternal mortality rate of zero per 100,000 live births, while Mexico reported a rate of 38 deaths per 100,000 live births. However, the regions with the highest number of maternal deaths are Sub-Saharan Africa and Southern Asia, with differences between countries and regions often reflecting inequalities in health care services and access. Most causes of maternal mortality are preventable and treatable with the most common causes including severe bleeding, infections, complications during delivery, high blood pressure during pregnancy, and unsafe abortion. Maternal mortality in the United States In 2022, there were a total of 817 maternal deaths in the United States. Women aged 25 to 39 years accounted for 578 of these deaths, however, rates of maternal mortality are much higher among women aged 40 years and older. In 2022, the rate of maternal mortality among women aged 40 years and older in the U.S. was 87 per 100,000 live births, compared to a rate of 21 among women aged 25 to 39 years. The rate of maternal mortality in the U.S. has risen in recent years among all age groups. Differences in maternal mortality in the U.S. by race/ethnicity Sadly, there are great disparities in maternal mortality in the United States among different races and ethnicities. In 2022, the rate of maternal mortality among non-Hispanic white women was about 19 per 100,000 live births, while non-Hispanic Black women died from maternal causes at a rate of almost 50 per 100,000 live births. Rates of maternal mortality have risen for white and Hispanic women in recent years, but Black women have by far seen the largest increase in maternal mortality. In 2022, around 253 Black women died from maternal causes in the United States.

Estimates based on District hospital discharge data. Counts of and rates based on fewer than 10 births are suppressed for privacy reasons.

Source: Center for Policy Planning and Evaluation, DC Department of Health

Why This Matters

In recent decades, pregnancy-related deaths have risen in the United States. Although relatively rare and mostly preventable, the numbers are high relative to other high-income countries.

Leading underlying causes of pregnancy-related deaths include severe bleeding, cardiac and coronary conditions, and infections. Individual, social, and structural factors contribute to maternal death risk and trends, including maternal age, preexisting medical conditions, access to quality care, insurance, and longstanding racial and ethnic inequities.

Maternal mortality rates are disproportionately higher among birthing people who are Black, Indigenous, and people of color.

The District Response

Enhancements to District healthcare programs. Medicaid expansion provides greater access to prenatal care, extended postpartum Medicaid coverage for a full year, and reimbursement for doula services through all District programs. For a list of local and national resources on pregnancy and related topics, click here.

Paid family leave program providing 12 weeks to bond with a new child or care for a serious health condition, and 2 weeks specifically for prenatal care.

The District established the Maternal Mortality Review Committee, which investigates the causes of maternal deaths, and develops strategic frameworks to improve maternal health.

Statistics on maternal mortality are produced based on the database of causes of death. "Maternal deaths" are selected from the database via a complex procedure, which takes into account the definition given by the WHO and is described in detail in the metadata. The tenth revision of the International Classification of Diseases (ICD-10) defines maternal death as "the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes." "Maternal deaths should be subdivided into two groups. Direct obstetric deaths: those resulting from obstetric complications of the pregnant state (pregnancy, labour and puerperium), from interventions, omissions, incorrect treatment, or from a chain of events resulting from any of the above. Indirect obstetric deaths: those resulting from previous existing disease or disease that developed during pregnancy and which was not due to direct obstetric causes, but which was aggravated by physiologic effects of pregnancy." Furthermore, the ICD-10 also defines late maternal death as "the death of a woman from direct or indirect obstetric causes more than 42 days but less than one year after termination of pregnancy." The "maternal mortality rate" is the ratio between the number of recorded direct and indirect maternal deaths over one year and the number of live birth in the same year, expressed per 100,000 live births. Late maternal deaths are not taken into account in the calculation of this ratio. Given the small and markedly variable number of cases recorded each year in Belgium, it has been decided to calculate this ratio based on the cumulated maternal deaths and live births of five consecutive years, with the ratio calculated being recorded in the middle year. When identifying these maternal deaths, the ad hoc working group, bringing together the Belgian statistical office and all data producing federated entities, did not exclude the risk of an underestimation of these deaths, based on the only statistical bulletin used as main source. It therefore asks for continued efforts to further improve the follow-up of maternal deaths, and supports the recent initiative of the College of physicians for Mother and Newborn to consider the creation of a maternal mortality register.

The dataset contains year and state wise Maternal Mortality Ratio

The World Health Organization (WHO) defines maternal death as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.

Note: Maternal Mortality Ratio (MMR) is derived as the proportion of maternal deaths per 1,00,000 live births reported under the SRS.

In 2023, non-Hispanic Black women had the highest rates of maternal mortality among select races/ethnicities in the United States, with 50.3 deaths per 100,000 live births. The total maternal mortality rate in the U.S. at that time was 18.6 per 100,000 live births, a decrease from a rate of almost 33 in 2021. This statistic presents the maternal mortality rates in the United States from 2018 to 2023, by race and ethnicity.

This data presents national-level provisional maternal mortality rates based on a current flow of mortality and natality data in the National Vital Statistics System. Provisional rates which are an early estimate of the number of maternal deaths per 100,000 live births, are shown as of the date specified and may not include all deaths and births that occurred during a given time period (see Technical Notes).

A maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. In this data visualization, maternal deaths are those deaths with an underlying cause of death assigned to International Statistical Classification of Diseases, 10th Revision (ICD-10) code numbers A34, O00–O95, and O98–O99.

The provisional data include reported 12 month-ending provisional maternal mortality rates overall, by age, and by race and Hispanic origin. Provisional maternal mortality rates presented in this data visualization are for “12-month ending periods,” defined as the number of maternal deaths per 100,000 live births occurring in the 12-month period ending in the month indicated. For example, the 12-month ending period in June 2020 would include deaths and births occurring from July 1, 2019, through June 30, 2020. Evaluation of trends over time should compare estimates from year to year (June 2020 and June 2021), rather than month to month, to avoid overlapping time periods. In the visualization and in the accompanying data file, rates based on death counts less than 20 are suppressed in accordance with current NCHS standards of reliability for rates. Death counts between 1-9 in the data file are suppressed in accordance with National Center for Health Statistics (NCHS) confidentiality standards.

Provisional data presented on this page will be updated on a quarterly basis as additional records are received. Previously released estimates are revised to include data and record updates received since the previous release. As a result, the reliability of estimates for a 12-month period ending with a specific month will improve with each quarterly release and estimates for previous time periods may change as new data and updates are received.

United States US: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data was reported at 28.000 Ratio in 2013. This records an increase from the previous number of 13.000 Ratio for 2007. United States US: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data is updated yearly, averaging 13.000 Ratio from Dec 1996 (Median) to 2013, with 3 observations. The data reached an all-time high of 28.000 Ratio in 2013 and a record low of 7.600 Ratio in 1996. United States US: Maternal Mortality Ratio: National Estimate: per 100,000 Live Births data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s USA – Table US.World Bank: Health Statistics. Maternal mortality ratio is the number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births.; ; UNICEF, State of the World's Children, Childinfo, and Demographic and Health Surveys.; ;

In 2020, it was determined that 83.5 percent of pregnancy-related deaths in the United States were preventable. That is, there was at least some chance of the maternal death being averted by one or more reasonable changes to patient, community, provider, facility, and/or systems factors. The U.S. has one of the highest maternal mortality rates among developed nations, and maternal mortality is disproportionately high among non-Hispanic Black women. This statistic shows the percentage of pregnancy-related deaths in the U.S. that were preventable in 2020.

Context

The Maternal Mortality Ratio (MMR) is a crucial indicator within the Gender Inequality Index (GII), an encompassing measure designed to assess gender disparities and inequities within a society. The GII, an extension of the Human Development Index (HDI), focuses on three primary dimensions: reproductive health, empowerment, and economic activity. Reproductive health, one of the key dimensions, sheds light on the challenges faced by individuals based on their gender. Within this context, the Maternal Mortality Ratio specifically gauges the number of maternal deaths per 100,000 live births, providing insight into the disparities in health outcomes experienced by women. This indicator reflects the state of maternal health and underscores the importance of addressing reproductive rights to mitigate gender inequalities.

Content

This dataset encompasses extensive historical information regarding gender development indicators on a global scale. Key columns include ISO3 (the ISO3 code assigned to each country/territory), Country (the name of the country or territory), Continent (the continent of the country's location), Hemisphere (the hemisphere in which the country is positioned), Human Development Groups, UNDP Developing Regions, HDI Rank (2021) representing the Human Development Index Rank for the year 2021, and Maternal Mortality Ratio (deaths per 100,000 live births) spanning from 1990 to 2021.

Dataset Glossary (Column-wise)

• ISO3 - ISO3 for the Country/Territory
• Country - Name of the Country/Territory
• Continent - Name of the Continent
• Hemisphere - Name of the Hemisphere
• Human Development Groups - Human Development Groups
• UNDP Developing Regions - UNDP Developing Regions
• HDI Rank (2021) - Human Development Index Rank for 2021
• Maternal Mortality Ratio (deaths per 100,000 live births) from 1990 to 2021 - Maternal Mortality Ratio from 1990 to 2021

Data Dictionary

• UNDP Developing Regions:
  • SSA - Sub-Saharan Africa
  • LAC - Latin America and the Caribbean
  • EAP - East Asia and the Pacific
  • AS - Arab States
  • ECA - Europe and Central Asia
  • SA - South Asia

Structure of the Dataset

https://i.imgur.com/d1iGY3d.png" alt="">

Acknowledgement

This Dataset is created from Human Development Reports. This Dataset falls under the Creative Commons Attribution 3.0 IGO License. You can check the Terms of Use of this Data. If you want to learn more, visit the Website.

Cover Photo by: Image by gstudioimagen1 on Freepik

Thumbnail by: Baby icons created by Victoruler - Flaticon

Women 40 years and over have the highest rates of maternal mortality in the United States. In 2023, the rate of maternal mortality among this age group was around 60 per 100,000 live births. This statistic presents maternal mortality rates in the United States from 2018 to 2023, by age group.

Maternal mortality ratio of United States of America sank by 15.00% from 20.0 deaths per 100,000 live births in 2022 to 17.0 deaths per 100,000 live births in 2023. Since the 40.91% jump in 2021, maternal mortality ratio plummeted by 45.16% in 2023. Maternal mortality ratio is the number of women who die during pregnancy and childbirth, per 100,000 live births. The data are estimated with a regression model using information on fertility, birth attendants, and HIV prevalence.

State of Palestine (West Bank and Gaza) PS: Maternal Mortality Ratio: Modeled Estimate: per 100,000 Live Births data was reported at 45.000 Ratio in 2015. This records a decrease from the previous number of 47.000 Ratio for 2014. State of Palestine (West Bank and Gaza) PS: Maternal Mortality Ratio: Modeled Estimate: per 100,000 Live Births data is updated yearly, averaging 67.000 Ratio from Dec 1990 (Median) to 2015, with 26 observations. The data reached an all-time high of 118.000 Ratio in 1990 and a record low of 45.000 Ratio in 2015. State of Palestine (West Bank and Gaza) PS: Maternal Mortality Ratio: Modeled Estimate: per 100,000 Live Births data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s State of Palestine (West Bank and Gaza) – Table PS.World Bank.WDI: Health Statistics. Maternal mortality ratio is the number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births. The data are estimated with a regression model using information on the proportion of maternal deaths among non-AIDS deaths in women ages 15-49, fertility, birth attendants, and GDP measured using purchasing power parities (PPPs).; ; WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division. Trends in Maternal Mortality: 1990 to 2015. Geneva, World Health Organization, 2015; Weighted average; This indicator represents the risk associated with each pregnancy and is also a Sustainable Development Goal Indicator for monitoring maternal health.

Data on infant, neonatal, postneonatal, fetal, and perinatal mortality rates by selected characteristics of the mother. Please refer to the PDF or Excel version of this table in the HUS 2019 Data Finder (https://www.cdc.gov/nchs/hus/contents2019.htm) for critical information about measures, definitions, and changes over time.

SOURCE: NCHS, National Vital Statistics System, public-use Linked Birth/Infant Death Data Set, public-use Fetal Death File, and public-use Birth File. For more information on the National Vital Statistics System, see the corresponding Appendix entry at https://www.cdc.gov/nchs/data/hus/hus19-appendix-508.pdf.

From 2019 to 2021, there were over ** infant deaths per 1,000 live births among non-Hispanic Black women who were obese before pregnancy in the United States. This statistic illustrates the rate of infant mortality in the United States from 2019 to 2021, by maternal pre-pregnancy body mass index and race/ethnicity.

Abstract

The Government of The Gambia has always been committed to the “Health for All” year 2000 and beyond Alma Ata Declaration (1978) as well as other conventions such as the 1987 Global Conference on Safe Motherhood, the 1990 Convention on the Rights of the Child and the 1994 ICPD-Cairo Plan of Action, amongst others. A unique recommendation from all these conventions was the reduction of maternal mortality by half by the year 2000 and the provision of a comprehensive reproductive health programme using the life cycle approach from birth to death.

The 1987 conference on safe motherhood brought about increased awareness in the health sector on the issue of maternal mortality following which the “sisterhood” method of estimating levels of maternal mortality was first tested in The Gambia in 1987. This field test was done by the MRC field station located in one of the rural divisions of The Gambia and a total of 90 maternal deaths were identified. The lifetime risk of maternal death was estimated to be higher than one woman in twenty (Greenwood et al.). Subsequently, this revelation by the MRC study sparked a new impetus into the “silent epidemic” of maternal mortality following which the Department of State for Health through its MCH/FP programme commissioned a national survey in 1990. The results, which were quite startling, revealed a maternal mortality level of 1,050 per 100,000 live births nationally. There were variations between urban (600 per 100,000) and rural communities with trained birth attendants (894 per 100,000), and communities without trained birth attendants (1,600 per 100,000).

Recent isolated studies on maternal mortality have suggested a general decline in those areas. However, in the absence of a viable vital registration system in The Gambia, there has been a felt need to conduct another national survey, since the 1990 survey. Furthermore, the Department of State for Health’s proposed shift from MCH/FP service provision into a broad-focussed reproductive health programme also requires the availability of current baseline information and the identification of relevant process indicators, all of which justify the need to establish current levels of mortality and use of contraceptives.

It should be noted that current national policies and programmes continue to refer to data obtained from the 1990 maternal mortality study, the 1990 Gambia contraceptive prevalence and fertility determinants survey as well as the 1993 population and housing census as baseline benchmarks both for programme intervention and implementation. This long period to some extent renders the data quite obsolete and unsuitable for many national and development purposes. A simple compromise has been that of making comprehensive demographic, health and socio-economic projections. However, one important limitation of statistical projections is the period between the time the base data were collected and the time span of the projections. The probable margin of error in making projections with reference periods of eight or more years ago could be so large to warrant the acceptance of such projections within any reasonable statistical intervals.

Since there has been no comprehensive national survey on maternal, infant and child mortality during the past 10 years, and given that it would take a number of years before the final analyses of data obtained from the forthcoming census, it was found prudent to carry out a comprehensive study that would collect information on key reproductive health indicators. Furthermore, the complexity involved in studying maternal mortality compounded by its rarity of occurrence in the general population has necessitated conduction of a specialised study. Such a study would be useful in filling in the data deficiencies and providing baseline data for programme intervention and evaluation, especially in an era of a general shift of emphasis of population programmes from vertical family planning activities in favour of a more generally accepted concept - reproductive health.

Objectives of the survey: a) To establish current levels of maternal, peri-natal, neonatal and infant mortality rates. b) To establish the current levels of contraceptive prevalence rates and barriers to use. c) To elicit how the situation has improved or otherwise during the last ten years. d) Make practical recommendations to Department of State for Health for subsequent and long-term actions required.

Geographic coverage

National.

Analysis unit

• Households
• Women and men (both in child-bearing age)

Universe

The survey covered women age 15 to 49 years old and men age 18 years and over.

Kind of data

Sample survey data [ssd]

Sampling procedure

A multi-stage stratified cluster sampling procedure was used for this study. The country is divided into 41 Districts and each of these districts was identified as a stratum. Stratification by districts increases the efficiency of the sample given the homogeneity of the districts. The sample size for the study was 4000 households and was based on the level of maternal mortality which was estimated at 1050 per 100,000 at the time of the study. According to WHO/UNICEF, 1997 publication on Sisterhood Method in Estimating Maternal Mortality, 4,000 households or less would be adequate for study of maternal mortality if the level of maternal mortality is at least 500 per 100,000.

Based on the Rule of Thumb, a 15 per cent sample of EAs (240) was selected for this study, which is also more than adequate for the study of other variables like contraceptive prevalence, infant mortality, fertility and its determinants. The selection of population elements were done at two stages; a representative sample of 240 Enumeration Areas (EAs) were randomly selected and allocated based on the Probability Proportional to the Size (PPS) of the district using random numbers. The EA is a cluster of settlements with an estimated population of 500 peoples.

A total of 4,000 households were then allocated to the districts with probability proportional to the size of each district. For the 240 selected EAs, a specified number of households were randomly selected for interview using a systematic sampling procedure. A complete listing of selected household members was done and all eligible male and female respondents were interviewed.

Sampling deviation

There were no discrepancies between the sample units obtained and the iniitial planned samples.

Mode of data collection

Face-to-face [f2f]

Research instrument

The survey tools included a compound and household schedules, female and male questionnaires. The compound and household schedules were used to collect information on local government area, health division and household number, together with residence, sex, age, education and eligibility status of the household members. The female and male questionnaires were administered to women aged 15-49 years and men aged 18 years and above respectively. The survey instruments were similar to the core modules of the Demographic and Health Survey questionnaires (Macro International), with adaptation to suit The Gambian needs. In addition a review of medical records in the three main hospitals in The Gambia (Royal Victoria Hospital, Farafenni Hospital and Bansang Hospital) was carried out in November 2001 to undertake first-hand assessment of the maternal mortality situation at the major referral facilities.

The Survey team with support and guidance of the Technical Team prepared the survey instruments by adapting the Demographic and Health survey modules. The main instruments for this study are: - Male questionnaire which was used to obtain information from males 18 years and above; - Female questionnaire, which obtained information from females, 15-49 years ; - Household questionnaire contains information on Local Government Area (LGA), Districts and Household numbers.

For each person listed on the household questionnaire, relationship to head of household, age, and sex are recorded.

The female questionnaire contains the following key information: - Respondent's background - Reproduction - Contraception - Marriage - Fertility preferences - Maternal mortality

The male questionnaire on the other hand, contained the following information: - Respondent's background - Contraception - Marriage - Maternal mortality

Response rate

All respondents with missing age were excluded from the model. There were about 15 percent of the responses with missing information on the deaths. Imputations were made to establish whether or not they qualified to be classified as maternal deaths. For instance, those missing sex of the sibling but had correctly answered maternal death-related questions, the sex was taken to be female and therefore included in the maternal mortality model. Responses with no information on the type of maternal death, but had indicated the death as having been as a result of complications of pregnancy or child birth, were imputed to be pregnancy-related. On the other hand, responses on symptoms before death were used to impute the type of death in case it was missing.

Data appraisal

All respondents with missing age were excluded from the model. There were about 15 percent of the responses with missing information on the deaths.

This comprehensive dataset provides a detailed state-wise analysis of maternal health indicators in the United States from 2016 to 2021. It covers a broad spectrum of metrics such as maternal mortality rates, prenatal vitamin usage, insurance coverage during pregnancy, and numerous other critical health indicators. Each state is represented with data that includes both weighted percentages and confidence intervals, offering a nuanced view of maternal health across different regions. The dataset is an invaluable resource for understanding the dynamics of maternal health in the U.S., identifying trends, and pinpointing areas that require attention or intervention. It is particularly useful for healthcare researchers, policy analysts, and public health officials seeking to develop targeted strategies to improve maternal health outcomes and reduce disparities among different states and communities.

Abstract Introduction Maternal mortality represents an event of great magnitude in Brazil and worldwide. The occurrence of maternal death reflects the lack of access to health services and unfavorable socioeconomic conditions. Objective To correlate maternal changes and puerperal pregnancy outcome in maternal death. Methods Cross-sectional and retrospective study. We used data collected from 53 medical records of pregnant women and postpartum women who died at a Reference State Hospital in high risk gestation in Goiás. Results Mortality occurred in women aged 20 to 34 years (76%), single (55%), first pregnancy (38%), from the interior of the State (60%) and 62% had the childbirth at the institution of the study. The main obstetric causes were 55% direct and 24% indirect, being predominant in the puerperal period (83%). The maternal mortality ratio was 228.4. There was a significant association between complications at childbirth and the place of birth (P = 0.001). Conclusion The maternal death occurred in single women, of reproductive age, coming from other counties, for direct causes and in the puerperium. It is necessary to improve the access to health services in obstetrics, since most cases are preventable.

In 2022, the infant mortality rate in the United States was 5.4 out of every 1,000 live births. This is a significant decrease from 1960, when infant mortality was at around 26 deaths out of every 1,000 live births. What is infant mortality? The infant mortality rate is the number of deaths of babies under the age of one per 1,000 live births. There are many causes for infant mortality, which include birth defects, low birth weight, pregnancy complications, and sudden infant death syndrome. In order to decrease the high rates of infant mortality, there needs to be an increase in education and medicine so babies and mothers can receive the proper treatment needed. Maternal mortality is also related to infant mortality. If mothers can attend more prenatal visits and have more access to healthcare facilities, maternal mortality can decrease, and babies have a better chance of surviving in their first year. Worldwide infant mortality rates Infant mortality rates vary worldwide; however, some areas are more affected than others. Afghanistan suffered from the highest infant mortality rate in 2024, and the following 19 countries all came from Africa, with the exception of Pakistan. On the other hand, Slovenia had the lowest infant mortality rate that year. High infant mortality rates can be attributed to lack of sanitation, technological advancements, and proper natal care. In the United States, Massachusetts had the lowest infant mortality rate, while Mississippi had the highest in 2022. Overall, the number of neonatal and post neonatal deaths in the United States has been steadily decreasing since 1995.

This data collection consists of two data files, which can be used to determine infant mortality rates. The first file provides linked records of live births and deaths of children born in the United States in 1983 (residents and nonresidents). This file is referred to as the "numerator" file. The second file consists of live births in the United States in 1983 and is referred to as the "denominator" file. Variables include year of birth, state and county of birth, characteristics of the infant (age, sex, race, birth weight, gestation), characteristics of the mother (origin, race, age, education, marital status, state of birth), characteristics of the father (origin, race, age, education), pregnancy items (prenatal care, live births), and medical data.