maternal mortality

High Cost of Pregnancy: Maternal mortality rates increase dramatically with black women bearing the burden

The U.S. maternal mortality rate increased to 32.9 deaths per 100,000 live births in 2021 from 23.8 in 2020, according to data released today by the Centers for Disease Control and Prevention. Dr. Iffath Abbasi Hoskins, president of the American College of Obstetricians and Gynecologists, said this is a stunning 40% increase in preventable deaths in a statement to USA Today. The data also revealed alarming evidence of racial disparity among these deaths, with black women bearing the overwhelming costs.

Maternal Mortality Rates in the US Rose at an Alarming Pace

The World Health Organization defines maternal mortality as, “the annual number of female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy.” The CDC used these metrics to analyze data from 2021, which showed a spike in maternal mortality rates across women of all backgrounds. Experts estimate that about 25% of these deaths can be attributed to the pandemic; however, most agree that the data shows problematic gaps in our healthcare system.

According to the American Journal of Managed Care, the US has the highest rate of maternal mortality among the world’s developed countries. Most maternal deaths, per the CDC – are preventable. The United States’ maternal death rate continues to be higher than other wealthy, developed countries, and the new data shows a roughly 60% increase in overall rates in 2021 from 2019, the year before the start of the pandemic.

Clear Evidence of Inequity and Racial Disparity

Women of color, specifically black women, account for a disproportionate number of these preventable deaths. The maternal mortality rate for non-Hispanic Black birthing people was 69.9 deaths per 100,000 live births, or 2.6 times the rate for non-Hispanic White birthing people. That compares to a maternal mortality rate of 55.3 deaths per 100,000 live births in 2020 among Black birthing people, the CDC said.

Sara Heath of  Patient Engagement HIT writes, “Those unequal increases demonstrate that, despite calls to the contrary, the US hasn’t ameliorated its Black maternal health disparities problem.” According to the Mayo Clinic, A host of factors contribute to the increase in mortality, including:

  • Underlying chronic conditions
  • Unconscious or implicit bias
  • Economic, physical and emotional health
  • Access to care
  • Variation in the quality of prenatal and postpartum care

Maternal Mortality Increases as Access and Options for Healthcare Decrease

As maternal mortality rates increase, states across the nation are limiting healthcare options for women. Multiple studies have found that states with more abortion restrictions have higher rates of maternal and infant mortality. Healthcare experts warn that maternal deaths are likely to increase as new restrictions are imposed on women’s health care.

In addition to restrictive abortion and birth control legislation, women are also facing a decrease in health care clinics and a loss of health care and nutrition funding. About 2 million rural women of childbearing age live at least 25 miles away from a labor and delivery unit, a USA TODAY analysis found. Some urban communities are also losing their labor and delivery units.

Preventing Preventable Deaths

Experts agree that the majority of maternal deaths are preventable.Organizations such as the Commonwealth Fund and World Health Organization have recommended the following policies based on evidence gathered from extensive research:

  • Prevent unintended pregnancies. All women, including adolescents, need access to contraception, safe abortion services to the full extent of the law, and quality post-abortion care.
  • Provide all women with access to high quality care in pregnancy, and during and after childbirth. Pay particular attention to inequities in care and access to care for vulnerable populations.
  • Make critical investments to address social determinants of health including systematic racism, sexism, classism, and xenophobia.


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