HealthThe US maternal mortality rate rose sharply in 2021, and could get worse

The US maternal mortality rate rose sharply in 2021, and could get worse

The US maternal mortality rate rose sharply in 2021, and could get worse

(CNN) — As women die in pregnancy or childbirth each year in the United States, new federal data shows that the nation’s maternal mortality rate has risen significantly once again in 2021, with rates among black women more than twice those of black women. of white women.

Experts said the current maternal mortality crisis in the United States was exacerbated by Covid-19, leading to a “dramatic” rise in deaths.

The number of women who died of maternal causes in the United States increased to 1,205 in 2021, according to a report from the National Center for Health Statistics, released Thursday by the US Centers for Disease Control and Prevention (CDC, by its acronym in English). That’s a sharp increase from previous years: 658 in 2018, 754 in 2019 and 861 in 2020.

That means the maternal mortality rate in the United States for 2021—the year for which the most recent data is available—was 32.9 deaths per 100,000 live births, compared with rates of 20.1 in 2019. and 23.8 in 2020.

Racial disparities in maternal mortality rates

The new report also points to significant racial disparities in the country’s maternal mortality rate. In 2021, the rate for black women was 69.9 deaths per 100,000 live births, which is 2.6 times the rate for white women of 26.6 per 100,000.

The data showed that the rates increased with the age of the mother. In 2021, the maternal mortality rate was 20.4 deaths per 100,000 live births for women under 25 years of age and 31.3 for those 25 to 39 years of age, but it was 138.5 for those 40 years of age. or more. That means the rate for women older than 40 was 6.8 times the rate for women younger than 25, according to the report.

The maternal mortality rate in the United States has risen steadily over the past three decades, and these increases have continued during the covid-19 pandemic.

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Questions remain about how the pandemic may have affected maternal mortality in the United States, according to Dr. Elizabeth Cherot, health and medical director of the March of Dimes maternal and child health nonprofit, who was not involved in the new report.

“What happened in 2020 and 2021 compared to 2019 was covid,” Cherot said. “This is kind of my reflection on this time period, covid-19 and pregnancy. Women were at higher risk of covid morbidity and mortality. And that was actually well shown in some studies, showing increased risk of death, but also intensive care unit ventilation, preeclampsia and blood clots, all of those things that increase the risk of morbidity and mortality.”

The American College of Obstetricians and Gynecologists (ACOG) previously expressed “great concern” that the pandemic would worsen the US maternal mortality crisis, ACOG President Dr. Iffath Abbasi said. Hoskins, in a statement Thursday.

Covid-19 causes global increase in pregnancy problems 0:38

“Interim data released in late 2022 in a US Government Accountability Office report indicated that maternal mortality rates in 2021 had skyrocketed, largely due to covid-19. Still, the confirmation of an approximately 40% increase in preventable deaths compared to the previous year is surprising news,” Hoskins said.

“The new NCHS data also shows a nearly 60% increase in maternal mortality rates in 2021 from 2019, just before the start of the pandemic. The covid-19 pandemic had a dramatic and tragic effect on maternal mortality rates, but we cannot let that fact obscure that there was already, and still is, a worsening maternal mortality crisis.”

Health officials emphasize that pregnant people should be vaccinated against covid-19 and that doing so offers protection for both mother and baby.

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During the early days of the pandemic, in 2020, there was limited information on the risks and benefits of the vaccine during pregnancy, causing some women to wait to get vaccinated. But now, there is increasing evidence of the importance of getting vaccinated to protect against serious diseases and the risks of covid-19 during pregnancy.

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The Covid-19 pandemic may also have exacerbated existing racial disparities in the maternal mortality rate among black women compared to white women, said Dr. Chasity Jennings-Nuñez, a California-based site director with Ob Hospitalist. Group and chair of the perinatal team in Adventist Health-Glendale’s Department of Gynecology, who was not involved in the new report.

“In terms of maternal mortality, those structural and systemic issues that we saw so clearly during the covid-19 pandemic continue to stand out,” Jennings-Nuñez said.

“So, in terms of racial inequalities in health, of racism and structural bias, of access to health care, all of those factors that we know have played a role in terms of maternal mortality in the past continue to play a role in maternal mortality.” , said. “Until we start to address those issues, even without a pandemic, we will continue to see the numbers go in the wrong direction.”

covid-19 risks during pregnancy 1:19

“This is a problem in our country”

Some policies to address the maternal health crisis have been introduced in the United States, including the Black Maternal “Momnibus” Act of 2021, a sweeping package of bipartisan bills that aims to provide and postnatal support for black mothers, including extension of eligibility for certain postpartum benefits.

As part of the Momnibus, President Biden signed the bipartisan Serving Mothers Protection Act of 2021, and other provisions passed the House.

In the United States, about 6.9 million women have little or no access to maternal health care, according to the March of Dimes, which has been advocating in support of Momnibus.

The US has the highest maternal mortality rate of any developed nation, according to the Commonwealth Fund and the most recent data from the World Health Organization. While maternal mortality rates have been stable or increasing in the United States, they are declining in most countries.

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“A high rate of C-sections, inadequate prenatal care, and elevated rates of chronic diseases such as obesity, diabetes, and heart disease may all be contributing factors to the high maternal mortality rate in the US Many maternal deaths are the result of treatment opportunities. lost or delayed,” Commonwealth Fund researchers wrote in a report last year.

The continued rise in maternal deaths in the United States is “disappointing,” said Dr. Elizabeth Langen, a high-risk maternal-fetal physician at the University of Michigan Health’s Von Voigtlander Hospital for Women. She was not involved in the latest report, but she cares for people who have had serious complications during pregnancy or childbirth.

“Those of us who work in the maternity care space have known for a long time that this is a problem in our country. And every time new statistics come out, we’re hopeful that some of the efforts that have been going on will change the direction of this trend. It’s really disappointing to see that the trend is not going in the right direction but, on some level, it’s going in the wrong direction and at a slightly faster pace,” Langen said.

“In the health care system, we must accept final responsibility for the women who die in our care,” she added. “But as a nation, we must also accept some responsibility. We need to think about: how do we provide maternity care that is right for people? How do we allow people time off work to see their midwife or doctor so they can get the care they need? How do all of us make it possible to live a healthy life while you are pregnant so that you have the chance to have the best possible outcome?”


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