Maternal Deaths in the US Keep Rising

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Maternal mortality rates in the United States have more than doubled in two decades, according to a new study published July 3 in the Journal of the American Medical Association (JAMA).

Maternal deaths are those that happen during or up to one year after pregnancy.

The study found an estimated 1,210 maternal deaths in 2019, compared to 505 in 1999. The most deaths occurred among Black women, while the largest increases in deaths were found in American Indian and Native Alaskan mothers.

“Maternal mortality is a crisis in the United States. These rates have been increasing over the past several decades and were exacerbated by the pandemic,” said study author Dr. Allison Bryant, senior medical director for health equity at Mass General Brigham.

Researchers looked at maternal deaths between 1999 and 2019–but not the pandemic spike–for every state and five racial and ethnic groups.

For years, the United States has had one of the highest maternal mortality rates of any country in the industrialized world. Further, maternal deaths in the United States have steadily increased, while other high-income countries such as Australia, Japan, and the Netherlands have seen declines.

These other wealthy countries, with lower death rates for new mothers, approach the problem differently, Dr. Elizabeth Cherot, chief medical and health officer at the maternal health nonprofit March of Dimes, told NPR.

“They wrap services around new mothers. They give them [support for] everything from mental health, cardiovascular, diabetic, pelvic health. These things are just considered standard,” but are not universally offered to individuals postpartum in the U.S.

Dr. Karen Joynt Maddox, a health services and policy researcher at Washington University School of Medicine in St. Louis who wasn’t involved in the study, noted that compared with other wealthy nations, the United States under-invests in things like social services, primary care, and mental health.

Many pregnancy-related deaths are preventable when mothers receive care during and after pregnancy. Mental health conditions, hemorrhage, heart conditions, infections, and thrombotic embolism account for the majority of pregnancy-related deaths.

“Most of the deaths we reviewed and other places have reviewed … were preventable,” said Dr. William Greenfield, the medical director for family health at the Arkansas Department of Health.

Thirty percent of pregnancy-related deaths occurred 43-365 days postpartum, according to Maternal Mortality Review Committees (MMRC) in 36 states (2017 to 2019).

About 23 percent of pregnancy-related deaths occurred seven to 42 days postpartum, while 12 percent took place between one to six days. Another 13 percent of deaths occurred on the day of delivery. The remaining 21 percent occurred during pregnancy.

In recent years, Republican and Democrat lawmakers have recognized the high maternal mortality rate among women leading more states to pass legislative measures to extend Medicaid postpartum coverage from 60 days to 12 months.

“The year that follows delivery is a very vulnerable year for the pregnant person,” Annie Glover, a senior research scientist at the University of Montana’s Rural Institute for Inclusive Families, told KFF Health News.

More than 4 out of 10 births in the United States are covered by Medicaid, according to the CDC (pdf).

Medicaid provides health coverage for more than 86 million low-income adults, children, pregnant women, the elderly, and individuals with disabilities. The plan is administered by the states and funded by the states and federal government.

Jana Pruet and The Associated Press contributed to this report.