Earlier this month, The National Center for Health Statistics, Centers for Disease Control released a National Vital Statistics Report on Maternal Mortality in 2019 in the United States.   You can access the entire report from the CDC website by clicking here.

A maternal death is defined by the World Health Organization as:

“the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.”

In 2019, 754 people lost their life from maternal causes in the United States. The maternal mortality rate for 2019 was 20.1 deaths per 100,000 live births. In 2018, 658 people died from maternal causes and the maternal mortality rate was 17.4 per 100,000.

2019 brought 96 more deaths and a significantly higher maternal mortality rate.

The United States continues to have the worst maternal mortality rate of all the world’s industrialized countries.  It is estimated that 66% of the maternal deaths that occurred in 2019 were preventable.

In 2019, the maternal mortality rate for non-Hispanic black women was 44.0 deaths per 100,000 live births, 2.5 times the rate for non-Hispanic white women (17.9) and 3.5 times the rate for Hispanic women (12.6).  Rates for non-Hispanic black women were significantly higher than rates for non-Hispanic white and Hispanic women. The increase in the maternal mortality rate from 2018 (14.9) to 2019 for non-Hispanic white women was statistically significant. The observed increases from 2018 to 2019 for non-Hispanic black women and Hispanic women were not significant.  Racism is a public health issue and the greater risk of dying as a Black expectant or postpartum parent is shameful and demands increased action, legislation and funding immediately.

As a start, the Congressional Black Maternal Health Caucus’ Momnibus that Caucus members introduced in March is a package of nine bills that each implement specific measures to promote maternity care for women disproportionately affected by maternal mortality and morbidity, and who have poorer childbirth outcomes than the national average.  You can learn more about this bill package and how Lamaze International supports this important legislation here.

Around one-third of U.S. pregnancy-related deaths, counted up to one year postbirth, occur during pregnancy

• 17 percent of deaths occur on the day of delivery.
• 52 percent occur after delivery, or postpartum:
• 19 percent of all maternal deaths occur between one and six days postpartum.
• 21 percent of all maternal deaths are between one and six weeks postpartum.
• 12 percent of all maternal deaths take place during the remaining portion of the year; these are also known as late maternal deaths.

The most common causes of maternal death are hemorrhage, high blood pressure and infection.  Deaths that occur late in the postpartum time are most likely to be cardiomyopathy.

Two conclusions that contribute to the overall high number of maternal deaths compared to other industrialized nations is a relative undersupply of maternity care providers, especially midwives, and the absence of  comprehensive postpartum supports. (Roota, T. 2020)

Parents are dying unnecessarily and many maternal deaths can be prevented. Black parents disproportionately face a higher risk of death while growing their families than their white and Hispanic counterparts. 2019 rates have been identified as moving in the wrong direction.  Action must be taken now.

References

Hoyert DL. Maternal mortality rates in the United States, 2019. NCHS Health E-Stats. 2021. DOI: https://doi.org/10.15620/cdc:10385

Roosa Tikkanen et al., Maternal Mortality and Maternity Care in the United States Compared to 10 Other Developed Countries (Commonwealth Fund, Nov. 2020). https://doi.org/10.26099/411v-9255

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