Maternal mortality increased dramatically during pandemic

Black, Hispanic women had higher death rates in 2021, officials report.

The rate of Americans dying while giving birth — or in the weeks afterward — increased by more than one-third in 2021 compared with a year earlier, with the burden of death disproportionately borne by communities of color, according to a report released last week by U.S. health officials.

The number of maternal deaths jumped to 1,205 in 2021, up from 861 the previous year, according to the report from the National Center for Health Statistics. This means the rate at which all people died of medical conditions caused or aggravated by pregnancy increased from 23.8 to 32.9 deaths per 100,000 live births.

This was the third consecutive year the nation’s maternal mortality rate, long the highest among high-income nations, increased, a jump the report said was “significant” for all racial and ethnic groups.

In 2021, according to the report, the maternal mortality rate for Hispanic women jumped about 54 percent, white women 39 percent and Black women 26 percent. That was the year

the nation marked a gruesome milestone in the pandemic: By September 2021, 1 in every 500 Americans had succumbed to the disease caused by the coronavirus.

Although the new report does not mention the pandemic, maternal health experts said it was natural to assume the coronavirus fueled the rise in maternal deaths. Research has shown that pregnant women infected with the coronavirus have a seven times higher risk of dying compared with pregnant women who are not infected.

Camille Clare, chair of the department of obstetrics and gynecology at SUNY Downstate Health Sciences University in New York, said women infected with the coronavirus also had higher rates of complications, were more likely to be admitted to intensive care and saw an increase in neonatal issues, meaning more preterm births.

“The COVID-19 pandemic really had a dramatic effect on those maternal death rates on top of the crisis that was already present,” she said.

Still, the shroud of death woven from pregnancy and childbirth did not cover all communities equally. The mortality rate was highest for Black women in 2021: 69.9 deaths per 100,000 births, or 2.6 times the rate for white women.

The increase in deaths underscores what public health experts exploring the nation’s higher rates of maternal and infant mortality — and why Black women and infants are more likely to experience complications and death — have come to understand, said Kanika Harris, director of maternal and child health at the Black Women’s Health Imperative, which works to improve the health and wellness of Black women and girls.

“You can’t solve this issue by focusing on the process of being pregnant and birth,” Harris said. “It’s not just that moment in time.”

That’s why it’s a top predictor of a nation’s health, she said, because maternal health is informed by an accumulation of life events that start long before pregnancy and that are centuries in the making. Experts and federal officials acknowledge that addressing maternal mortality means understanding the effects imposed on expectant mothers by racism, housing policy, policing, climate change, pollution — and the pandemic.

KYLE GREEN/AP 2021 A pregnant and intubated COVID-19 patient lies in the surgical intensive care unit in a hospital in Boise, Idaho, in 2021. More than 1,200 U.S. women died during pregnancy or shortly after childbirth that year, health officials reported last week.