There is a maternal health crisis in the United States, and even states with the best health care are experiencing concerning maternal health outcomes. A new report from the Massachusetts Department of Public Health found the state’s rate of severe maternal morbidity (SMM)—which researchers define as unexpected complications in labor or delivery resulting in significant consequences such as heart attacks, kidney failure, and sepsis—has nearly doubled from 2011 to 2020.
The report also underscored the widening gap and persistent health disparities in maternal health among Black and white women, as researchers found the highest rate of SMM among Black women compared to any other racial and ethnic group.
“Massachusetts has the best health care system in the country, but this report shows that there is much more work that we need to do to address racial and gender inequities in health care. It is essential that everyone has access to comprehensive, high-quality and inclusive maternal health care,” said Governor Maura Healey, in a statement. “We can and must do better for mothers, for kids and for families–and our administration is committed to doing just that.”
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The report conducted a retrospective analysis of 678,382 deliveries, which included both live births and fetal deaths, of 483,699 Massachusetts residents between 2011 and 2020. Over the 10-year period, SMM rates nearly doubled, increasing from 52.3 per 10,000 deliveries in 2011 to 100.4 per 10,000 deliveries in 2020.
Additional findings include:
- The highest SMM rates were consistently among Black, non-Hispanic women, with inequities increasing an average of 10.1 percent each year.
- In 2011, SMM rates among Black women was twice that of white women. By 2020, SMM rates were 2.5 times higher among Black women compared to white women, which is a 25 percent gap increase.
- SMM rates also increased among all other racial and ethnic groups, with rates increasing 7.8 percent per year on average for white women, 8.2 percent for Hispanic women, and 10.5 percent for Asian/Pacific Islander women.
- Women with disabilities, particularly intellectual, vision, and mobility-related disabilities, also experienced higher rates of SMM, with 131.6 SMM deliveries per 10,000 deliveries among women with intellectual deliveries, 108.4 among women with a vision disability, and 94.6 among women with a mobility disability.
“When we look at maternal health outcomes through a lens of race and ethnicity, we see a different picture of our health care system,” said Secretary of Health and Human Services Kate Walsh, in the report announcement. “Birthing people, particularly women of color, face devastating levels of risk. We have a lot of work to do to improve outcomes, and this report is a call to action that tells us where we need to focus our efforts to address the root causes of maternal health complications and close the racial gap.”
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The report findings underscore the need for enhanced monitoring and increased support in maternal health, said researchers, who called for state policy efforts targeting structural racism, as well as improved access to quality primary and prenatal health care.