Home / Science / Health /  US maternal mortality hits highest level since 1965

Maternal deaths surged to the highest rate in nearly 60 years, data showed, exacerbating a yearslong trend that has made the U.S. the most dangerous place among high-income countries to give birth.

The number of women who died during pregnancy or shortly afterrose 40% to 1,205 in 2021, compared with 861 in 2020 and 754 in 2019, the National Center for Health Statistics said Thursday. The increase pushed the maternal-mortality rate to 33 deaths per 100,000 live births, the highest since 1965, compared with 24 in 2020 and 20 in 2019.

Covid-19 and disruptions during the pandemic added to pressure from factors including cardiovascular problems and healthcare disparities that have worsened maternal health in recent years, doctors and health officials said.

“It’s heartbreaking," said Dr. Nawal Nour, chair of the department of obstetrics and gynecology at Brigham and Women’s Hospital in Boston. “We’ve worked so hard to get the trend going the right way, and it just doesn’t seem like we’re heading there."

Black mothers were the most affected. The mortality rate among Black women was 2.6 times as much as the rate for white women in 2021, and 30% of maternal deaths were among Black women. Black people make up about 14% of the U.S. population, Census Bureau data show. The mortality rate for Hispanic mothers overtook that among white women in 2021, and maternal deaths were more common among women 40 years or older than among younger women.

Maternal-death rates are higher in the U.S. than in any other high-income country. The rates in France, the U.K. and Canada were eight, 10 and 11 deaths per 100,000 live births respectively in 2020, according to the World Health Organization. Maternal-mortality rates in the U.S. rose 78% between 2000 and 2020, while dropping in most other countries, the WHO said.

Cardiovascular conditions such as pulmonary embolisms, uncontrolled bleeding and problems stemming from hypertension are the leading causes of pregnancy-related deaths in the U.S., according to the Centers for Disease Control and Prevention.

Some pregnancy and postpartum complications probably stem from rising obesity and declining heart health in the U.S., doctors said. Around 42% of U.S. adults are considered obese, nearly half have high blood pressure, around 11% have diabetes and 38% have prediabetes, the CDC said.

Covid-19 made matters worse. Pregnantwomen are at higher risk of severe illness or death from Covid-19, especially if they aren’t vaccinated. People were less likely to get necessary care during the pandemic because of lockdowns and fear of catching the virus, research shows. Black people were hospitalized and died at higher rates than white people, data show.

“It’s sad but not surprising," said Dr. Veronica Gillispie-Bell, an obstetrician and gynecologist and associate professor at Ochsner Health, a health system in New Orleans. Higher death rates for Black women reflect disparities including lack of healthcare access in some communities, she said. Healthcare providers are more likely to overlook the concerns of Black patients, studies have shown.

“There’s a growing understanding of the social determinants of health, such as economic stability and educational opportunity, that contribute to pregnancy-related mortality," said Shanna Cox, associate director for science at the CDC’s division of reproductive health.

Two days after Shamony Gibson of Brooklyn, N.Y., came home from the hospital with her baby boy, Khari, in September 2019, she began experiencing chest pain and shortness of breath, said her partner, Omari Maynard. They called the hospital several times and were told she might be moving too much and needed to rest, Mr. Maynard said.

Two weeks later Ms. Gibson, 30 years old, collapsed in their home and went into cardiac arrest. Emergency medical services workers rushed her to a hospital. The next morning, she died. The cause of death, Mr. Maynard said, was listed as a pulmonary embolism, which occurs when a blood clot blocks an artery in the lung.

“It’s still a really hard pill to swallow, to this day," Mr. Maynard said. He is raising Khari, now 3, and a sister, Anari, 6, with support from extended family.

Blood clots are treatable if caught early, doctors said. More than 80% of pregnancy-related deaths in the U.S. are preventable, public-health officials and doctors said. Work to improve heart health should start long before pregnancy, doctors said.

“Heart health entering pregnancy has gotten worse in the past decade," said Dr. Sadiya Khan, assistant professor of medicine at Northwestern University Feinberg School of Medicine. “Prepregnancy is the time to really optimize maternal outcomes."

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