Pregnancy-related deaths climbed in first year of pandemic

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

Overall 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.

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Among Black people, there were 55 maternal deaths per 100,000 births — almost triple the rate for whites.

The report from the National Center for Health Statistics does not include reasons for the trend and researchers said they have not fully examined how COVID-19, which increases risks for severe illness in pregnancy, might have contributed.

A pregnant woman visits the gynecologist (iStock)

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 health care system, which could have an impact on pregnancy-related deaths, said Eugene Declercq, a professor and maternal death researcher at Boston University School of Public Health.

He called the high rates "terrible news" and noted that the U.S. has continually fared worse in maternal mortality than many other developed countries.

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Pregnancy-related deaths per 100,000 births climbed from 44 in 2019 to 55 in 2020 among Black people and from 13 to 18 among Hispanics. The 2020 rate among whites, 19 per 100,000 births, was essentially unchanged.

Reasons for those disparities are not included in the data. But experts have blamed many factors including differences in rates of underlying health conditions, poor access to quality health care and structural racism.

"This is incredibly sad news and especially scary for Black women," said Dr. Laura Riley, OB-GYN chief at Weill Cornell Medicine in New York.

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Dr. Janelle Bolden, an assistant OB-GYN professor at Northwestern University’s Feinberg School of Medicine, said the report is not surprising.

"The pandemic has uncovered the disparities in access to care, healthcare quality and delivery. 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."

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The U.S. maternal mortality rate has more than tripled in 35 years. A decade ago, it was 16 deaths per 100,000 births. It has climbed along with rising rates of obesity, heart disease and cesarean sections, which all increase risks for people giving birth.