The National Center for Health Statistics said on Thursday that the number of women who died during or shortly after pregnancy is set to rise by 40% to 1,205 in 2021, compared to 861 in 2020 and 754 in 2019. The increase brought the maternal mortality rate to 33 deaths per 100,000 live births, the highest since 1965, compared to 24 in 2020 and 20 in 2019.
Doctors and health officials said Covid-19 and disruptions during the pandemic have added to the pressure of factors, including cardiovascular problems and health disparities, that have worsened maternal health in recent years.
“It’s heartbreaking,” said Dr. Naval Noor, chairman of the department of obstetrics and gynecology at Brigham and Women’s Hospital in Boston. Like we’re going there.”
Black mothers were most affected. The death rate among black women was 2.6 times the rate for white women in 2021, and 30% of maternal deaths were among black women. Census Bureau data shows that black people make up about 14% of the US population. The death rate for Hispanic mothers surpassed that of white women in 2021, and maternal deaths were more common among women age 40 or older than among younger women.
The US has a higher maternal mortality rate than any other high-income country. According to the World Health Organisation, the rates in France, the UK and Canada were eight, 10 and 11 deaths per 100,000 live births respectively in 2020. The WHO said maternal mortality in the US rose 78% between 2000 and 2020, while it fell in most other countries.
According to the Centers for Disease Control and Prevention, cardiovascular conditions such as pulmonary embolisms, uncontrolled bleeding and complications from high blood pressure are the leading causes of pregnancy-related deaths in the US.
Some pregnancy and postpartum complications probably stem from rising obesity and declining heart health in the US, doctors said. The CDC states that about 42% of American adults are considered obese, about half have high blood pressure, about 11% have diabetes and 38% have prediabetes.
Covid-19 made matters worse. Pregnant women are at higher risk of serious illness or death from COVID-19, especially if they have not been vaccinated. Research shows that people were less likely to get needed care during the pandemic due to lockdowns and fear of catching the virus. Black people were hospitalized and died at higher rates than white people, the data show.
“It’s sad but not surprising,” said Dr. Veronica Gillispie-Bell, an obstetrician and gynecologist and associate professor at Ochsner Health, a health system in New Orleans. The higher death rate for black women reflects disparities, including a lack of health care in some communities. , He said. Studies have shown that healthcare providers are more likely to ignore the concerns of black patients.
“There is a growing understanding of the social determinants of health, such as economic stability and educational opportunity, that contribute to pregnancy-related mortality,” said Shanna Cox, associate director of science in the CDC’s division of reproductive health.
Two days after Shamoni Gibson of Brooklyn, NY, came home from the hospital with her baby, Khari, in September 2019, she started having chest pains and shortness of breath, said her partner, Omari Maynard. Mr Maynard said he called the hospital several times and was told she must be shaking too much and needed to rest.
Two weeks later Ms Gibson, 30, collapsed in her home and suffered a cardiac arrest. Emergency medical service workers took him to the hospital. The next morning, she died. The cause of death, Mr. Maynard said, was listed as pulmonary embolism, which occurs when a blood clot blocks an artery in the lung.
“It’s a really tough pill to swallow, even today,” Mr. Maynard said. He’s raising Khari, now 3, and a sister, Anari, 6, with support from extended family.
Doctors said that blood clots can be treated if caught early. Public-health officials and doctors said that more than 80% of pregnancy-related deaths in the US could be prevented. Doctors say that work to improve heart health should start long before pregnancy.
“Cardiovascular health entering pregnancy has worsened over the past decade,” said Dr. Sadia Khan, assistant professor of medicine at Northwestern University Feinberg School of Medicine. “Pregnancy is really a time to optimize maternal outcomes.”