From the American Journal of Obstetrics and Gynecology:

The high and rising rates of maternal mortality in the United States are a consequence of changes in maternal mortality surveillance, with reliance on the pregnancy checkbox leading to an increase in misclassified maternal deaths. Identifying maternal deaths by requiring mention of pregnancy among the multiple causes of death shows lower, stable maternal mortality rates and declines in maternal deaths from direct obstetrical causes.

Translation: maternal mortality often went undetected, so they changed the way we had to measured it. We don’t like how the new way of measuring is making us look compared to other countries, so we want to change it back. Goodhart wins again. (↬Washington Post)