Health Desk – 01 Apr, 2021: The Rate of Maternal mortality in the U.S. increased by more than 15% in 2019, a new report from the Centers for Disease Control and Prevention shows.
The surge occurred as the country was on the brink of the COVID-19 pandemic and its disruption of traditional medical care. The full impact of the pandemic on maternal health outcomes remains to be seen, though some have feared it could worsen what’s already considered a crisis.
“COVID-19 is the third-leading cause of death in the United States for this year, and in those numbers are people who are pregnant,” says Dr. Neel Shah, an assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School. The CDC has said that pregnant people face higher risks of severe illness from COVID-19.
Shah, who was not involved in the new study, adds that even if there wasn’t a massive change in maternal mortality during the pandemic, COVID-19 disrupted the care and well-being of moms, including early on when support people were shut out of delivery rooms.
Overall, 96 more women died while pregnant or within 42 days of their pregnancy in 2019 than in 2018 – 754 compared with 658. That translated to 20.1 deaths per 100,000 live births in 2019, up from 17.4 per 100,000 in 2018 for what the report called a significant increase.
Black women still suffered from the highest rate of maternal mortality when compared with white and Hispanic women, the report found. Though an uptick from 37.3 per 100,000 live births in 2018 did not mark a statistically significant increase, according to the report, Black women’s rate of 44 deaths per 100,000 in 2019 was 2.5 times the rate of 17.9 for white women, continuing a key racial disparity that experts and advocates have been working to close.
“One of the clear and leading indicators that structural racism is a clear and present danger to people’s lives is maternal mortality,” Shah says.
The rate for Black women also was 3.5 times the rate for Hispanic women, which was 12.6. And the maternal death rate in 2019 did rise significantly for white women, according to the report, increasing by 20% from 14.9 deaths per 100,000 live births in 2018.
Additionally, maternal death rates increased by age group, and differences between groups were significant. Though the rate for women 40 and older didn’t change significantly, for example, it was six times higher at 75.5 deaths per 100,000 live births than the rate for women under 25, which was 12.6 deaths per 100,000.
Meanwhile, the rate for women 25 to 39 years old significantly increased, from 16.6 deaths per 100,000 live births in 2018 to 19.9 deaths per 100,000 in 2019.
Shah notes that some of the report’s statistics may be artifacts due to a lag in maternal mortality reporting and varied reporting across states. He also says it’s too early to know if recent policy interventions made much of a difference in maternal mortality.
Still, he says, finer data points need not overshadow the larger message the report sends.
“Every maternal death is a tragedy,” Shah says, adding that most of these deaths are preventable.
Data depicts the U.S. as having a dismal maternal mortality rate in comparison with other high-income countries, and the new CDC report marks just the second release of an official maternal mortality rate for the country in more than a decade.
Shah notes that while recent policies aimed at curbing maternal mortality are a step in the right direction – the latest COVID-19 relief package, for example, included a provision giving states the option to extend Medicaid coverage up to one year postpartum – there’s still more to get done.
He adds that more care providers also are needed – including providers of color – to ensure not only that people survive childbirth, but that they feel respected and cared for as well.
“Surviving is a very low bar when we’re talking about people giving birth,” Shah says. “We should be aiming way, way higher. And the goal is dignity, and part of that is making sure that you’re safe and the rest of it is making sure people have a role in the care that they want.”