Abstract
BACKGROUND: Pregnancy increases the risk of homicide, particularly for women facing intimate partner violence (IPV). Limited existing data suggests significant variation by state. METHOD: Using data from the National Violence Death Reporting System (NVDRS), we analyzed maternal homicide by U.S. state from January 1, 2018, to December 31, 2022. We assessed the prevalence of manners of death and proportion linked to IPV. RESULTS: From 47 states during the 5-year period, 637 maternal homicides were identified, for a rate of 5.33 per 100,000 live births. Firearms accounted for 78% of deaths, and 51% were associated with IPV. Only 15 states had sufficient data for reliable state-level rate calculations. Three states had 0 reported maternal homicides. Of the remaining 12, Louisiana had the highest rate at 12.64 per 100,000 live births while New York had the lowest at 2.86 per 100,000 live births. CONCLUSIONS: The national maternal homicide rate aligns with prior research but reveals notable state-level differences where data were available. Restrictions on rate reporting for most states highlights a major gap in surveillance, limiting efforts to address this critical public health issue. Reliable state-level data is essential for understanding and addressing the factors driving maternal homicides.