Pregnancy care is becoming more complex. Are you prepared?

By Matt LaMar

Throughout the 20th century, modern medical science transformed pregnancy from a high risk-condition into something far more routine. A hundred years ago, there were hundreds of maternal deaths for every 100,000 live births. Today, that number is 17.

But there’s still work to be done to make pregnancy even safer. The United States still lags behind many of its peers in pregnancy care safety, and the most recent data shows a 50% increase in maternal mortality since even the 1990s.

While the reasons for this shift are many, the good news is that family medicine is poised to truly make a positive impact on the pregnancy care landscape.

Not every pregnancy carries the same risk, and one of the biggest impacts on maternal mortality is age at the time of pregnancy. The older a pregnant patient is, the greater the complication rate.

According to a 2025 report from the CDC, there has been a steady and significant change in the demographic mix of pregnancies in just the previous seven years. In 2016, 39.3% of all first births occurred under the age of 25, while 32.3% of all first births occurred over the age of 30. Just seven years later, those figures nearly flipped: In 2023, 37.6% of all first births occurred over the age of 30 while 33.9% of first births occurred under the age of 25. And in 2023, the average age at second pregnancy eclipsed 30 years old for the first time.

This follows an established trend of people waiting until later in life to have children in the United States, and it has continued to accelerate. Even controlling other factors, this trend simply means that more pregnancies are at higher risk than they ever have been.

Another contributing factor to the higher risk of pregnancies is chronic conditions. One of the chronic conditions on the rise in the United States is obesity, and that includes pregnant patients. From 2016 to 2022, the number of pregnant patients with obesity increased from 26% to 32%.

But obesity isn’t the only condition with potential adverse health effects during pregnancy. Pre-existing diabetes can impact pregnancy, and there has been a steady increase in Americans with diabetes for years. The United States has also seen an increase in other chronic conditions, such as kidney disease and cardiovascular disease, which the American Heart Association predicts will increase in prevalence over the next few decades.

Family physicians and your teams can positively impact maternal health outcomes—even if your clinic doesn’t deliver babies. Primary care is at the forefront of tackling chronic conditions, and by helping your patients address obesity and other chronic diseases you are impacting maternal health, too.

Also, there are many educational opportunities available. Attend one of our 2026 Pregnancy and maternal health conferences and shore up your skills. This summer, the AAFP will present a pair of maternal health events:

“You will learn a ton by attending this year’s conference,” says Lee Dressang, MD, the chair of this year’s FCPC conference. “Acquire and advance your procedural skills through clinical procedure workshops, learn the latest on vaccines in pregnancy and dive into influential obstetric publications in the past year. Everyone has fun, makes friends and leaves with a renewed enthusiasm for pregnancy care.”

No individual can solve maternal health trends on their own. But together, family physicians can positively impact your communities and work together to achieve better health.