Maternal mortality is “unacceptably high” in the United States, according to a new study published by JAMA Network, which found maternal deaths in the U.S. to have increased from 505 in 1999 to 1,210 maternal deaths in 2019. Maternal deaths were highest among Black women, and there was the greatest increase in maternal deaths over time among American Indian and Alaska Native women.
"Maternal mortality is a crisis in the United States. These rates have been increasing over the past several decades and were exacerbated by the pandemic," said co-first author Allison Bryant, M.D., MPH, senior medical director for health equity at Mass General Brigham, in a statement. "Our study sheds light on the wide disparities within maternal mortality rates—the specter of maternal death differentially burdens some ethnic and racial populations."
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For the study, researchers from Mass General Brigham and the Institute for Health Metrics and Evaluation analyzed the state-level trends in maternal mortality by racial and ethnic groups in the U.S. using vital registration and census data from 1999 to 2019.
While the number of maternal deaths per 100,000 live births increased from 12.7 to 32.2 overall, there was a significantly disproportionate impact on racial and ethnic populations: Deaths rose from 14.0 to 49.2 among American Indian and Alaska Native individuals, from 26.7 to 55.4 among Black individuals, from 9.6 to 20.9 among Asian, Native Hawaiian, or Other Pacific Islander individuals, from 9.6 to 19.1 among Hispanic individuals, and from 9.4 to 26.3 among white individuals.
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Though the researchers found southern states to have the highest maternal mortality across all race and ethnic groups, they also identified disparities across the country.
"Often, states in the South are called out as having the worst maternal mortality rates in the nation, whereas California and Massachusetts have the best. But that doesn't tell the whole story," Bryant said in the statement. "It's essential to look at the disparities between populations that exist even in the 'best' states."
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While the study did not include data amid the pandemic, research has indicated that maternal death rates have only worsened, underscoring the need for increased efforts to improve health equity and maternal health care.
“Maternal mortality persists as a source of worsening disparities in many U.S. states and prevention efforts during this study period appear to have had a limited impact in addressing this health crisis,” wrote the research team.