Maternal deaths are dropping, but these moms still face high risk.
The number of women who died during childbirth or within weeks of giving birth dropped sharply in 2022 after staggering increases during the first two years of the COVID-19 pandemic, new data shows.
The Centers for Disease Control and Prevention on Thursday estimated 817 women died of maternal causes in the United States in 2022, marking a drop from 1,205 deaths in 2021 and 861 in 2020.
In 2022, the U.S. maternal death rate decreased to 22.3 per 100,000 births, compared with 32.9 deaths per 100,000 births in 2021. Provisional data suggest the death rate dropped again in 2023 to 19 deaths per 100,000 births, however, those figures must be confirmed with death certificates and other data, said Donna Hoyert, who tracks maternal mortality for the CDC's Division of Vital Statistics.
Black mothers nearly three times as likely to die during or after births
One thing has remained constant: Black women are far more likely to die during or shortly after childbirth than white women. The report highlights persistent disparities in maternal deaths, a concerning trend for public health experts that prompted former Surgeon General Jerome Adams in 2020 to declare a call to action to improve maternal health.
Maternal deaths among Black women decreased in 2022, but the number of people who died remained significantly higher than non-Black mothers, the CDC report shows. For Black mothers, the maternal mortality rate was 49.5 deaths per 100,000 births compared with 19 deaths per 100,000 for white women, 16.9 for Hispanic women and 13.2 for Asian women.
"The tragedy is that most pregnancy-related deaths are preventable," said Teresa Janevic, an associate professor of epidemiology at Columbia University's School of Public Health. "And that means that this disparity is preventable, too."
The World Health Organization defines maternal mortality as the death of a woman while she is pregnant or within 42 days of giving birth or terminating a pregnancy. The cause must be pregnancy-related, such as severe bleeding, infections, blood clots or mental health.
The CDC's Hoyert said deaths directly related to COVID-19 dropped considerably. In 2021, COVID-19 infections were listed as the cause or a contributing factor in 429 deaths ? in other words, more than 1 in 3 maternal deaths were COVID-related. In 2022, COVID-19 infections were linked to 88 maternal deaths, Hoyert said.
Beyond those direct deaths, the pandemic's harm surfaced in many other ways. Mothers lost jobs, health insurance and access to routine care. Pregnancy-related complications such as gestational diabetes and preeclampsia ? persistent high blood pressure during pregnancy or after giving birth ? became more common during the pandemic, said Linda Goler Blount, president of the nonprofit Black Women’s Health Imperative.
"Black women, low-income women, don't receive the standard of care even under the best of circumstances," Blount said. "So you had this very unfortunate conflation of social, medical and health care delivery events that increased maternal mortality for all women and particularly for Black women and low-income women."
Serena Williams' pregnancy complications reveal risk
Some factors can be attributed to social and economic inequalities. About 1 in 2 pregnancies nationwide are covered by Medicaid, the government health insurance program for low-income and disabled people. And in 10 mostly Southern states that have not expanded Medicaid under the Affordable Care Act, maternal deaths are worse, Blount said.
High-profile cases of Black women who have experienced pregnancy complications or death show that disparities afflict not just the poor and disenfranchised, Blount said.
In a first-person essay in the magazine Elle in 2022, tennis legend Serena Williams described her life-threatening experience after giving birth to her daughter Olympia in 2017. She needed a cesarean section and multiple surgeries with complications that put her perilously close to death.
Cedars-Sinai Medical Center, the Los Angeles hospital where Kim Kardashian, Beyoncé and other A-listers gave birth to their babies, is under federal civil rights investigation for how the hospital cares for Black maternal patients, the Los Angeles Times reported. The probe followed the 2016 death of a mother, Kira Dixon Johnson, at the facility from complications of a scheduled C-section after she delivered her son. Her husband, Charles Johnson IV, testified before Congress about the pain of losing his wife hours after she gave birth to their son.
"These high-profile figures have brought the issue into stark focus, and it's getting the attention that it has always deserved," Blount said.
Beyond racial disparities, age also is a risk factor. Women younger than 25 had the lowest rate of fatalities in 2022, with 14.4 deaths per 100,000 births. Women 40 and over had the highest maternal mortality rate at 87.1 deaths per 100,000 births.
This article originally appeared on USA TODAY: Maternal death rate is improving. So why do disparities persist?
