US maternal deaths rose sharply in 2020, with Black women hit hardest

The number of U.S. women who died during pregnancy or after childbirth increased during 2020, especially among Black and Hispanic women, according to a report released Feb. 23 by the National Center for Health Statistics. Officials attribute the rise in part to COVID-19 and pandemic-related disruptions. 

The number of maternal deaths rose 14 percent in 2020 compared to 2019, up from 754 deaths to 861. The nation's maternal mortality rate increased to 23.8 deaths per 100,000 live births in 2020, up from 20.1 deaths in 2019.  

"Our maternal morbidity and mortality is the highest in the developed world, and the trend is continuing despite our awareness of it, despite our maternal-mortality review committees, despite attention in the press," Kara Zivin, PhD, professor of psychiatry and obstetrics and gynecology at Ann Arbor-based University of Michigan, told The New York Times. "Whatever we're doing is clearly not enough to address either the overall rate or the disparities."

Black women experienced the most deaths, accounting for one-third of the maternal deaths in 2020, despite Black Americans making up a little more than 13 percent of the population. Black women's maternal mortality rate was nearly three times that of white women. The mortality rate for Hispanic women, which has historically been lower than that of white women, also rose significantly, now close to the rate for white women. Death rates increased especially for women 40 and older, whose mortality rate was nearly eight times that of women younger than 25. The report lacked maternal mortality figures for American Indian/Alaska Native women. 

Some of the deaths were likely tied to the pandemic, experts told the Times. Pregnant women with COVID-19 have a higher risk for severe disease, and vaccines weren't available in 2020. Additionally, many physicians had halted in-person care in 2020. Pregnant women with COVID-19 may face a higher risk of dying, studies have found. After vaccines became widely available, experts have urged pregnant Americans to get vaccinated, but their vaccination rates have remained low, according to the Times.

Overall, Black Americans have suffered disproportionately from the pandemic, though racial inequities in maternal mortality precede and extend beyond COVID-19.

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