aAfter years of increasing maternal mortality rates, the U.S. maternal mortality rate decreased in 2022. new government data show. But maternal and child health experts warn there is no reason to celebrate. The decline is a course correction after the COVID-19 pandemic, when mortality rates for mothers in the United States remain dramatically higher than for mothers in other high-income countries.
Racial disparities persist as well, with black mothers dying at more than 2.5 times the rate of white mothers in the United States, according to data released Thursday by the National Center for Health Statistics, part of the Centers for Disease Control. And prevention.
“This is truly an embarrassment to our country,” said March of Dimes President and CEO Elizabeth Cerotto. She said: “Too many mothers are dying. It doesn’t have to be that way.”
New data from the CDC shows there will be 22.3 maternal deaths per 100,000 live births in the United States in 2022, down from 32.9 in 2021. This data reflects 817 maternal deaths in 2022 and 1,205 in 2021.
The mortality rate for black mothers in 2022 will be 49.5 deaths per 100,000 live births, down from 69.9 deaths in 2021.
The U.S. maternal mortality rate rose continuously from 2018 to 2021, and increased particularly dramatically from 2020 to 2021 because COVID-19 was especially dangerous for pregnant women. The decline in the maternal mortality rate in 2022 will bring the maternal mortality rate back to its original state, which is the situation in 2019, before the outbreak of the new coronavirus disease (Covid-19) pandemic.
The CDC has not yet released maternal mortality rates for 2023, but some researchers expect maternal mortality rates to rise in states with restrictions on abortion following the Supreme Court’s Dobbs decision in mid-2022.
“This crisis is not over for us yet,” Cerotto said.
The maternal mortality rate in the United States is more than six times higher than those in Spain, Japan, Australia, and Germany, for example, according to an analysis of 2021-2022 data. Birth in numbers, The group is run by Eugene Decler, a professor of community health sciences at Boston University School of Public Health.
The reasons behind the high maternal mortality rate in the United States are complex; CDC analysis of data from 2017 to 2019 Evidence shows that more than 80% of pregnancy-related deaths in the United States are preventable. In that analysis, the three leading causes of death were mental health issues, including suicide and drug overdose. Excessive bleeding; heart and coronary artery conditions.
Part of the reason for the high maternal mortality rate in the United States is the high incidence of health problems such as: drug overdose, especially high in the United States. Another reason is inadequate medical care for many pregnant women in the United States. In 2022, 1 in 7 babies They were born to mothers who received inadequate prenatal care, according to the March of Dimes.
There is debate over how maternal mortality is calculated in the United States; March of Dimes And other experts say the rate is still higher than necessary, no matter how it is measured.
According to Birth by the Numbers, an extensive analysis of different reporting methods, “No matter how you frame the comparison, the United States does not fare well in comparisons between countries.”
The situation in the United States is especially bad for black mothers, with maternal mortality rates 2.6 times higher than for white women, according to new data from the CDC. The CDC states that several factors contribute to this severe racial disparity, including differences in the quality of health care and underlying chronic conditions, as well as systemic racism and inherent bias. ing.
“Structural racism doesn’t show up in the birth experience as a single villain. It’s not just the nurses or alumni who are racist, it’s the healthcare system that has policies and procedures that are enacted and enforced. It exacerbates racism,” said Ndidiamaka Amuta Onukaga, professor of Black maternal health at Tufts University School of Medicine and founder of the Center for Black Maternal Health and Reproductive Justice.
She said doctors and nurses “provide the same standard of care to all patients; [that] We treat everyone the same here. But then when we talk to patients, we get observational data, we look at emergency room and hospital discharge records, we find that there’s a lot of variation in how people are treated when they enter the health care system. ”
Mortality rates also vary greatly depending on where the person giving birth lives. A Births by the Numbers analysis of data from 2018 to 2021 found that Alabama, Arkansas, Mississippi and Tennessee had the highest maternal mortality rates, at least twice as high as the lowest states in the country. It is shown.
Alabama, Arkansas, Mississippi and Tennessee have enacted significant abortion restrictions since the Supreme Court’s June 2022 Dobbs decision overturning Roe v. Wade. Amuta Onukaga is a maternal and child health epidemiologist and co-author of the book. Article examining state abortion restrictions and maternal mortality ratessaid it expects the 2023 data to reflect the impact of these laws, which make it more difficult to terminate pregnancies that threaten the mother’s life.
“I definitely think they contribute to higher maternal mortality rates,” she says.
Over the years, several efforts have been made to prevent pregnancy-related deaths. hear her voice A campaign to raise awareness of urgent maternal warning signs and improve communication between pregnant women and their health care providers.There is also CDC initiatives Encourage countries to share strategies to reduce pregnancy-related deaths.
Monique Rainford, an obstetrician and assistant professor of medicine at Yale University School of Medicine, said the effects of these programs have not yet been reflected in maternal mortality rates.
“There are financial efforts being made to improve the situation. We’re seeing government efforts and conversations,” Rainford said. “But we haven’t seen the fruits of those investments yet. There are a lot of initiatives that need investment that haven’t been invested yet.”
This article is part of our ongoing coverage of reproductive health care. commonwealth fund.
