US maternal deaths rise during pandemic amid racial disparities

Pregnancy-related deaths for mothers in the United States climbed higher in the coronavirus pandemic’s first year, according to a government report, continuing a decades-long trend that disproportionately affects Black people.

A National Center for Health Statistics report published on Wednesday found that in 2020, there were almost 24 deaths per 100,000 births, or 861 deaths total – numbers that reflect mothers dying during pregnancy, childbirth or the year after. The rate was 20 per 100,000 in 2019.

Across the world, maternal mortality dropped throughout the 20th century, thanks to advances in medical care such as antibiotics and basic hygiene. But the US has seen backsliding since the year 2000, unlike most other countries.

In fact, the last time the US rate was officially this high was in 1968, though a new reporting methodology was introduced in 2018

Among Black people, there were 55 maternal deaths per 100,000 births in 2020 – almost triple the rate for white Americans.

“Black women are time and time again shown to not receive the same level of treatment or medications,” Ebony Hilton, an anesthesiologist at the University of Virginia, Charlottesville, told the AFP news agency.

Reasons for those disparities were not included in the data. But the report comes amid growing awareness over the structural racism in the US that affects Black Americans’ access to critical services such as healthcare and education.

Those disparities have a wide-ranging effect on the lives, health and wellbeing of Black people in the US, which experts say include differences in rates of underlying health conditions when compared with white Americans.

“The pandemic has uncovered the disparities in access to care, healthcare quality and delivery,” said Dr Janelle Bolden, an assistant OB-GYN professor at Northwestern University’s Feinberg School of Medicine. “It has also laid bare the lack of support for public health and social agencies that many people rely on for basic needs,” Bolden said. “These disparities and inadequacies lead to poor care and worse outcomes.”

Researchers said they have not fully examined how COVID-19, which increases risks for severe illness in pregnancy, might have contributed to the rising maternal deaths.

In the US, nearly 940,000 people have died of COVID-19 since the pandemic began, according to Johns Hopkins University – more than anywhere else in the world. And data shows that Black, Hispanics and Native Americans were disproportionately affected by the disease.

According to the US Centers for Disease Control and Prevention (CDC), Black Americans were 1.7 times more likely than white Americans to die from COVID-19. Black people were also 2.5 times more likely to be hospitalised for the disease.

The coronavirus could have had an indirect effect. Many people put off medical care early in the pandemic for fear of catching the virus, and virus surges strained the healthcare system, which could have an effect on pregnancy-related deaths, said Eugene Declercq, a professor and maternal death researcher at Boston University School of Public Health.

He said inadequate access to universal healthcare is also an important factor.

“Most of the peer countries have some form of universal healthcare,” Declercq told AFP.

“What we do in the United States is we focus on care so intently on the time of birth – and that’s nice – but the fact of the matter is, women enter their pregnancies in a less healthy state because they’re not covered.”

He called the high rates “terrible news” and noted that the US has continually fared worse in maternal mortality than many other developed countries.

In Canada, for instance, there were 7.5 deaths per 100,000 births in 2020, according to OECD statistics.

The new data comes as the maternal mortality rate has more than tripled in 35 years in the US. Ten years ago, it was 16 deaths per 100,000 births. It has climbed along with rising rates of obesity, heart disease and Caesarean section, which all increase risks for giving birth.