The maternal death rate in the United States is creeping upward — to more than double what it was 25 years ago. Systems identifying deaths have improved, so how much the increase can be attributed to risk is uncertain. “We have not seen a decrease in maternal mortality, and that is worrisome,” said Dr. George Saade, director of maternal-fetal medicine at UTMB. He said black women were three to four times more likely than white women to die from pregnancy. “These two things are very concerning, particularly in a developed country like the U.S.”