A new study by JAMA (The Journal of the American Medical Association) estimates– based on vital registration and census data from 1999 to 2019)– that maternal mortality has been steadily increasing in the US.
by Frank Butler , Orlando Advocate
While maternal mortality remains unacceptably high among all racial and ethnic groups in the US, Blacks and the American Indian and Alaska Native populations are most at risk. Between 1999 and 2019, Blacks had the highest median state MMR each year.
Maternal mortality is defined as a death that happens during or up to one year after the end of a pregnancy. It is measured by deaths per 100 000 live births. Some of the most common causes of death in these cases, according to the CDC (Centers for Disease Control), are excessive bleeding, infection, blood clots, cardiac and coronary conditions, cardiomyopathy, mental health conditions, and high blood pressure.
From 1999 to 2019, MMRs among Hispanics increased only slightly from 9.6 to 19.1 (deaths per 100,000 live births). Among Whites, the maternal mortality rate almost tripled– from 9.4 to 26.3. In each year between 1999 and 2019, the American Indian and Alaska Native population had the largest increases in median state MMRs, moving from 14.0 to 49.2. But for reasons still being explored, black women die more frequently than any other ethnic group after pregnancy. Their MMR increased from 26.7 to 55.4.
The study confirmed trends that researchers have already been observing– one of them being the extremely high mortality rates in Southern states. As expected, black mothers in the South experience the highest mortality rates overall.
Maternal mortality continues to be a source of worsening disparities in many US states, though, and high MMRs are not only found in the South.
New Jersey, for example, was the second-highest state for Black mortality in 2019 after Arizona, followed by New York, Washington, D.C., and Georgia. And New Jersey also saw the second-highest increase in Black mortality rates over the same period after Louisiana, followed by Georgia, Arkansas, and Texas.
For American Indian and Alaskan Native women, maternal mortality rates were highest in the Midwest and Great Plains states. That group saw the largest percentage increases in maternal mortality rates over the two-decade period in Florida, Kansas, Illinois, Rhode Island, and Wisconsin. Those increases spanned from 162% to 254.8%.
Efforts aimed at preventing high black MMR seem to have had limited impact in addressing this health crisis. It is impossible without more information to know why. As noted above, the study relies on “common causes of death” in determining reasons for mother deaths because researchers were not able to get access to actual cause of death information. Actual cause of death data is especially important for states that are looking to design interventions to decrease these numbers.