A comprehensive new state report reveals that 219 Illinois women died while pregnant or within one year of pregnancy during 2021-2022, with Black women facing mortality rates more than double those of White women and substance use disorders emerging as the leading cause of pregnancy-related deaths. The Illinois Department of Public Health’s latest maternal mortality data, published in November 2025, shows that nearly all these deaths were preventable.

The report, the fourth of its kind from IDPH, details how pregnancy-related mortality in Illinois increased significantly compared to previous years, reaching 36 deaths per 100,000 live births—up from 25 per 100,000 in 2017-2018. The 2021-2022 period marked the highest number of recorded pregnancy-associated deaths since the state implemented its current identification system in 2015, with 116 deaths in 2021 and 103 in 2022.

Black women in Illinois continue to experience worse outcomes, with pregnancy-related mortality rates more than twice as high as White women (78 deaths per 100,000 live births versus 33). The disparity is even more pronounced for medical conditions unrelated to substance use, where Black women were three times as likely to die from pregnancy-related medical complications.​

Hispanic women had the lowest pregnancy-related mortality ratio at 29 deaths per 100,000 live births, representing the only racial group to see a decrease compared to previous reporting periods. The gap between Black and Hispanic women has widened considerably over time, with Black women’s mortality rates increasing while Hispanic women’s rates declined.

Substance use disorder accounted for 29 percent of all pregnancy-related deaths in 2021-2022, making it the single largest cause of maternal mortality in Illinois. The next leading causes were thrombotic embolism (12 percent), COVID-19 (11 percent), and hemorrhage (10 percent).​

The report highlights that COVID-19-related deaths increased during the 2021-2022 period, which coincided with the pandemic’s peak impact in Illinois before widespread vaccine availability. Deaths from hemorrhage also doubled compared to the previous report, rising from 5 percent to 10 percent of pregnancy-related deaths.

Socioeconomic factors showed strong correlations with maternal death risk. Women with Medicaid insurance during pregnancy were over three times as likely to die from pregnancy-related causes compared to those with private insurance (59 versus 16 deaths per 100,000 live births). Women with a high school education or less faced higher mortality rates than those with more education, and women aged 40 or older were more than four times as likely to die as women younger than 25.

The Maternal Mortality Review Committees determined that 91 percent of pregnancy-related deaths were potentially preventable, with 19 percent having a “good chance” of prevention and 72 percent having “some chance.” For deaths caused by mental health conditions and substance use disorders, 100 percent were deemed potentially preventable.​

Contributing factors identified by reviewers included discrimination (present in 45 percent of Black women’s deaths versus 24 percent for White women), obesity (74 percent of Black women versus 27 percent for White women), and fragmented care systems. The report notes that discrimination—based on race, weight status, substance use disorder status, and insurance status—creates barriers to healthcare and negatively influences health outcomes.

The report’s recommendations align with the newly released Illinois Blueprint for Birth Equity, which outlines four transformative goals: optimizing healthcare quality, improving access, enhancing care coordination, and implementing data-driven solutions. Key recommendations include requiring comprehensive multidisciplinary care for women with underlying medical conditions, employing social workers to conduct psychosocial assessments before hospital discharge, and incentivizing providers to practice in rural and underserved areas.​

Hospitals are urged to implement trauma-informed care training, improve emergency department protocols for pregnant patients, and ensure timely transport to appropriate facilities. Community-based organizations are called upon to provide family-centered support programs for parents with substance use disorders.