Maternal mortality increased within the U.S. during the first year of the pandemic, particularly for non-Hispanic Black women and women aged 25 years and older, according to new data from the National Center for Health Statistics.
The country saw a total of 861 maternal deaths reported through 2020, up 14% from 754 in 2019 and 31% from 658 in 2018. The total number of live births also steadily declined each year from 3.79 million in 2018 to 3.61 million in 2020.
Those numbers translated to maternal mortality rates of 23.8 deaths per 100,000 live births in 2020, 20.1 deaths per 100,000 live births in 2019 and 17.4 deaths per 100,000 live births in 2018, according to the newly released Centers for Disease Control and Prevention data.
The government’s latest data show maternal death rates to be significantly higher among non-Hispanic Black women (55.3 deaths per 100,000 live births) when compared to non-Hispanic white women (19.1 per 100,000) and Hispanic women (18.2 per 100,000).
All three groups saw maternal mortality rates rise from 2019 to 2020, although only the increases among Hispanic women (12.6 per 100,000 to 18.2 per 100,000) and non-Hispanic Black women (44 per 100,000 to 55.3 per 100,000) were statistically significant, according to the agency.
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Maternal mortality rates were significantly higher within each increasing age bracket, starting at 13.8 deaths per 100,000 live births among those younger than 25 and increasing nearly eightfold to 107.9 deaths per 100,000 live births for those aged 40 or older.
While the agency found rate increases from 2019 to 2020 among every age group, only the year-over-year mortality increases among women aged 25 to 39 (19.9 per 100,000 to 22.8 per 100,000) and women aged 40 years and older (75.5 per 100,000 to 107.9 per 100,000) were statistically significant.
The center collected the data from the National Vital Statistics System mortality file and only included deaths of patients while pregnant or within 42 days of pregnancy “from any cause related to or aggravated by the pregnancy or its management.”
The agency wrote that the rates tend to fluctuate from year to year due to their relative rarity and, potentially, as a result of issues that arise when reporting maternal deaths on death certificates.
The new statistics do not describe whether the increase in maternal mortality rates coincided with any specific health complications, such as COVID-19. However, prior studies comparing pregnant women with and without a COVID-19 diagnosis have outlined “consistent and substantial increases” in maternal mortality, severe maternal morbidity and other neonatal complications.
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Even prior to the onset of the pandemic, maternal mortality rates in the U.S. far outstripped those of other wealthy and developed nations, per a 2020 Commonwealth Fund analysis. Calls to tackle the high national death rates, as well as the disparity in mortality rates among Black women and those of other underserved demographics, have been adopted by healthcare organizations such as the American Medical Association and the American College of Obstetricians and Gynecologists.
Tina Sherman, senior campaign director for maternal justice at grassroots organization MomsRising, said the “absolutely horrifying” statistics are a sign the country’s maternal and infant health are "getting appreciably worse” and called on lawmakers to take action on maternal mortality legislation introduced in the House last year.
“Too many mothers are losing their lives during childbirth,” Sherman said in a statement. “We want Congress to pass the [Black Maternal Health Momnibus Act of 2021] this year. It includes funds to address social determinants of health, support diversification of the perinatal health workforce, provide grants to improve maternal mental health, strengthen federal maternal health programs, and support anti-bias trainings for health care professionals. Its enactment will save lives and improve the health of mothers and babies. It is long, long overdue.”