July 3, 2023 -Maternal deaths across the U.S. more than doubled over the course of two decades, and the tragedy unfolded unequally.
Black mothers died at the nation’s highest rates, while the largest increases in deaths were found in American Indian and Native Alaskan mothers. And some states — and racial or ethnic groups within them – fared worse than others.
The findings were laid out in a new study published Monday in the Journal of the American Medical Association. Researchers looked at maternal deaths between 1999 and 2019 — but not the pandemic spike — for every state and five racial and ethnic groups.
“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,” said Dr. Allison Bryant, one of the study’s authors and a senior medical director for health equity at Mass General Brigham.
Among wealthy nations, the U.S. has the highest rate of maternal mortality, which is defined as a death during pregnancy or up to a year afterward. Common causes include excessive bleeding, infection, heart disease, suicide and drug overdose.
Bryant and her colleagues at Mass General Brigham and the Institute for Health Metrics and Evaluation at the University of Washington started with national vital statistics data on deaths and live births. They then used a modeling process to estimate maternal mortality out of every 100,000 live births.
Overall, they found rampant, widening disparities. The study showed high rates of maternal mortality aren’t confined to the South but also extend to regions like the Midwest and states such as Wyoming and Montana, which had high rates for multiple racial and ethnic groups in 2019.
Researchers also found dramatic jumps when they compared maternal mortality in the first decade of the study to the second, and identified the five states with the largest increases between those decades. Those increases exceeded: