It is unfortunately not news that the U.S. has one of the highest maternal mortality rates among high-income nations. But new findings released from The Centers for Disease Control and Prevention (CDC) show that 4 out of 5 pregnancy-related deaths are likely preventable.
In examining 1,018 pregnancy-related deaths in 36 states between 2017 and 2019, researchers found that in 84% of cases, a death could have been prevented had the provider or larger community taken additional steps or if healthcare access had been expanded.
Pregnancy-related deaths can occur anytime during pregnancy or birth, or up to one year after birth from a pregnancy complication. The report found that more than half (53%) of these preventable deaths occurred up to 12 months after birth, which indicates a strong need for more maternal follow-up visits after delivery. The six-week postpartum check-up simply isn’t enough.
“The report paints a much clearer picture of pregnancy-related deaths in this country,” said Wanda Barfield, M.D., M.P.H., director of CDC’s Division of Reproductive Health at the National Center for Chronic Disease Prevention and Health Promotion, in a press release. “The majority of pregnancy-related deaths were preventable, highlighting the need for quality improvement initiatives in states, hospitals, and communities that ensure all people who are pregnant or postpartum get the right care at the right time.”
The maternal mortality rate keeps growing
The report also highlights that not all communities receive the same level of maternal care, and as a result, the mortality rate is trending in the wrong direction.
In 2018, the maternal mortality rate was 17.4 deaths per 100,000 live births, and in 2020 it was 23.8 deaths per 100,000 live births, with Black and Indigenous communities among the most impacted.
Black women are three times more likely to die from pregnancy-related causes than white women. Indigenous women are two times more likely to die from pregnancy-related complications.
A study in JAMA found that these numbers continued to increase in the first year of the pandemic, reaching a rate of 25 deaths per 100,000 live births between April and December of 2020, again impacting Black and Indigenous communities the most.
“Due to systemic racism and discrimination at the individual level, Black women and birthing people face unacceptable (and mostly preventable) risk during childbirth and throughout and after pregnancy,” writes The Century Foundation.
What are common causes of maternal mortality?
Other causes of pregnancy-related death include:
- Cardiac and coronary conditions
- Blood clots
- High blood pressure
The complete list can be viewed here.
It’s also important to note that the majority of maternal deaths occur after delivery. Approximately 22% of deaths occurred during pregnancy, 25% occurred on the day of delivery (within 24 hours of the end of pregnancy) or within a week after delivery, 23% occurred from 7 to 42 days postpartum, and 30% occurred in the late postpartum period (43–365 days postpartum).
More provider support
The onus shouldn’t fall to pregnant people or new mothers to advocate for their own care in the days, weeks and months after giving birth. The authors of the CDC report stress the importance of the need for increased healthcare visits, more screening protocols and better insurance coverage for postpartum care.
ACOG advocates for at least one visit to an OBGYN or midwife within the first 3 weeks after delivery, with a comprehensive visit no later than 12 weeks, but the CDC stresses that the burden should fall to all healthcare providers—not just birth providers.
“It is critical for all healthcare professionals to ask whether their patient is pregnant or has been pregnant in the last year to inform diagnosis and treatment decisions. Healthcare systems, communities, families, and other support systems need to be aware of the serious pregnancy-related complications that can happen during and after pregnancy,” notes the agency in a press statement.
“Listen to the concerns of people who are pregnant and have been pregnant during the last year and help them get the care they need.”