U.S. maternal death rate rises for another year, CDC data show


As women die every year in the United States as a result of pregnancy or childbirth, new federal data shows that the national maternal mortality rate will rise sharply again in 2021, with black women dying at more than twice the rate of white women.

The 2021 Covid-19 pandemic has also claimed many lives, and while Covid-19 data is not part of the new report, some doctors are wondering what the disease might be doing to women who survive pregnancy and childbirth in the United States.

The number of women dying from maternal causes in the U.S. will rise to 1,205 in 2021, according to the National Center for Health Statistics report released Wednesday by the U.S. Centers for Disease Control and Prevention. That’s a big jump from a few years ago: 658 in 2018, 754 in 2019 and 861 in 2020.

That translates to a U.S. maternal mortality rate of 32.9 per 100,000 live births in 2021 (the most recent year for which data is available), compared to 20.1 in 2019 and 23.8 in 2020.

The new report also points to significant racial disparities in maternal mortality across the country. In 2021, the death rate for black women was 69.9 per 100,000 live births, 2.6 times higher than the rate for white women of 26.6 per 100,000.

The data showed that the rate increased as the mother got older. In 2021, the maternal mortality ratio will be 20.4 per 100,000 live births for women under 25, 31.3 for women between 25 and 39, but 138.5 for women 40 and over. According to the report, this means that women aged 40 and over are 6.8 times more likely to have the disease than women under 25.

Maternal mortality rates in the United States have been climbing steadily over the past three decades, and this upward trend has continued into the Covid-19 pandemic.

Dr. Elizabeth Cherot, chief medical and health officer at the March of Dimes, an infant and maternal health nonprofit who was not involved in the new report, said questions remain about how the pandemic is affecting maternal mortality in the United States.

“Compared to 2019, what’s happening in 2020 and 2021 is Covid,” Cherot said. “This is my reflection on this time, Covid-19 and pregnancy. Women are at increased risk of morbidity and mortality from COVID-19. This has actually been well documented in some studies, showed an increased risk of death, but also receive ventilation, preeclampsia and blood clots in the intensive care unit, all of which increase the risk of morbidity and mortality. ”

Pregnant women should be vaccinated against Covid-19, health officials stress, as doing so can provide protect mother and baby.

Early in the 2020 pandemic, limited information about the vaccine’s risks and benefits during pregnancy prompted some women to delay getting vaccinated.But now, there is growing evidence that vaccinations play a role in preventing serious illness and Risk of Covid-19 infection during pregnancy.

The Covid-19 pandemic may also have exacerbated existing racial disparities in maternal mortality among black women compared with white women, said Dr. Chasity Jennings-Nuñez, field director and perinatal/perinatal/ Adventist Health-Glendale’s department of gynecology chair, who was not involved in the new report.

“In terms of maternal mortality, it continues to highlight those structural and systemic issues that we saw very clearly during the Covid-19 pandemic,” Jennings-Nunez said.

“So in terms of racial health inequalities, structural racism and prejudice, access to health care, all of these factors that we know have had an impact on maternal mortality in the past and will continue to have an impact on maternal mortality. impact,” she said. “Until we start to address these issues, even without the pandemic, we will continue to see the numbers going in the wrong direction.”

A number of policies have been introduced to address the maternal health crisis in the United States, including The Black Maternity “Bus” Act of 2021a sweeping bipartisan bill to provide prenatal and postpartum support for black mothers, including expanding eligibility for certain benefits after childbirth.

President Biden signs bipartisan agreement as part of Momnibus Protecting Mothers Who Have Served In 2021, other provisions have passed the House of Representatives.

In the United States, approximately 6.9 million women have little or no access to maternal health care, According to March of Dimeswhich has been advocating for Momnibus.

The United States has the highest maternal mortality rate of any developed country, according to federal funds and the latest figures from the World Health Organization. While maternal mortality in the United States has been stable or rising, it is declining in most countries.

“High cesarean delivery rates, inadequate prenatal care, and rising rates of chronic conditions such as obesity, diabetes, and heart disease may be contributing factors to the high maternal mortality rate in the United States. Many maternal deaths are due to missed or delayed access to care,” The Commonwealth Fund wrote in a report last year.

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

“Those of us who work in maternity care have known for a long time that this is a problem in our country. Every time a new statistic comes out, we hope that some of the efforts that have been going on will change the direction of this trend. See Trends Not going in the right direction, but sort of going in the worst direction, and faster, is really disappointing,” Langan said.

“In the healthcare system, we need to take ultimate responsibility for the women who die in our care,” she added. “But we also need to take some responsibility as a country. We need to think: How do we give people proper care for mothers and babies? How do we give people time to go to a midwife or doctor so they can get the care they need? All of us How can one live a healthy life during your pregnancy so that you have the best chance of getting the best results?”

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