The rate of maternal mortality in the United States has more than doubled in the last two decades, and the tragedy has spread unevenly. While the death rate for black women was the highest in the country, it was greatest for American Indian and Native Alaskan mothers. Some states did worse than others, and some racial or ethnic groups within those states did much worse.
A new study detailing these results was published in the Journal of the American Medical Association on Monday. Researchers analyzed maternal mortality rates for all 50 states and 5 racial/ethnic groups between 1999 and 2019 (excluding the pandemic increase).
Author and senior medical director for health equity at Mass General Brigham Dr. Allison Bryant said, “It’s a call to action to all of us to understand the root causes, to understand that some of it is about health care and access to health care, but a lot of it is about structural racism and the policies and procedures and things that we have in place that may keep people from being healthy.”
The tweet below verifies the news:
Black mothers died at the nation’s highest rates, while the largest increases in deaths were found in American Indian and Native Alaskan mothers.
Some states — and racial or ethnic groups within them – fared worse than others. https://t.co/9borYnRvbE
— PBS NewsHour (@NewsHour) July 3, 2023
The United States has the highest rate of maternal mortality, which includes deaths occurring at any time during pregnancy or during the first year after birth, among developed countries. Excessive bleeding, illness, heart disease, suicide, and drug overdose are all common causes of death.
National vital statistics data on deaths and live births was the starting point for Bryant and her colleagues at Mass General Brigham and the Institute for Health Metrics and Evaluation at the University of Washington. After that, they utilized a modeling procedure to calculate the annual rate of maternal death per 100,000 live births.
In general, they discovered widespread and widening inequalities. Multiple racial and ethnic groups were found to have exceptionally high rates of maternal death in Wyoming and Montana in 2019, despite the fact that the study focused on the South.
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When comparing maternal death rates in the first and second decades of the study, researchers observed striking increases and pinpointed five states with the highest rates of rise. These rises were higher than: Indian and Alaskan Native mothers in the states of Florida, Illinois, Kansas, Rhode Island, and Wisconsin saw an increase of 162 percent;
135 percent for white mothers in Georgia, Indiana, Louisiana, Missouri and Tennessee;
105 percent for Hispanic mothers in Georgia, Illinois, Indiana, Minnesota, and Tennessee;
93 percent for Black mothers in Arkansas, Georgia, Louisiana, New Jersey, and Texas;
83 percent for Asian and Pacific Islander mothers in Georgia, Illinois, Kansas, Michigan, and Missouri.
“I hate to say it, but I was not surprised by the findings. We’ve certainly seen enough anecdotal evidence in a single state or a group of states to suggest that maternal mortality is rising,”, commented that there is sufficient anecdotal evidence in a single state or a group of states to show that maternal mortality is growing.
As one commenter put it, “It’s certainly alarming, and just more evidence we have got to figure out what’s going on and try to find ways to do something about this.” Maddox mentioned how the United States underinvests in primary care, mental health services, and social services as compared to other wealthy countries.
She also noted that Missouri had not extended Medicaid during the study’s time period and had not provided sufficient funding for public health. They’ve since approved a law providing Medicaid coverage for women and their newborns for a full year.
The Missouri state budget that Governor Mike Parson signed last week included $4.4 million to implement a strategy to reduce maternal mortality. A state report from 2021 found that pregnant Black women in Arkansas had twice the mortality rate of pregnant white women.
The state’s medical director for family health, Dr. William Greenfield, called the discrepancy substantial and said it has “persisted over time,” adding that the cause of the rise in maternal mortality in Arkansas among Black moms is unclear.
For decades, Black women have had the highest rates in the country, and this issue has no class boundaries. Tori Bowie, 32, an Olympic sprinting champion for the United States, passed away in May due to difficulties during childbirth.
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Bryant remarked that the pandemic had certainly worsened all of the demographic and geographic trends, adding, “that’s absolutely an area for future study.” Preliminary federal data suggests that after reaching a six-decade high in 2021—a jump that experts largely ascribe to COVID-19—maternal mortality decreased in 2022.
According to the government, the ultimate rate in 2022 is on course to approach the pre-pandemic level, which was still the highest in decades. Bryant emphasized the importance of learning more about these inequalities so that localized solutions may be prioritized and adequate funding can be allocated.
Greenfield, a professor of obstetrics and gynecology at the University of Arkansas Medical Center in Little Rock who was not involved in the study, noted that the state already uses telemedicine and is working on various other approaches to expand access to treatment.
The state is also home to a network known as the “perinatal quality collaborative,” whose purpose is to educate medical professionals on how to prevent delivery traumas and problems, manage hypertensive disorders, and reduce the number of necessary cesarean sections.
“Most of the deaths we reviewed and other places have reviewed … were preventable,” Greenfield said.
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