Homicide is a leading cause of death in pregnant people, a new study finds. Black women are at greatest risk.

Part of what made this study novel was that 2018 was the first year every state had added a pregnancy checkbox to their death certificates. In 2003, the National Center for Health Statistics had revised its policies for issuing death certificates, requiring states to record on death certificates whether the decedent had been pregnant, less than 42 days postpartum or less than one year postpartum. But states were slow to implement the change.