The Maternal Mortality Rate Dipped For Black Women. The Reason Is Complicated.
After a sharp rise in the number of women dying in childbirth, which was likely due to the COVID-19 pandemic, new data shows that the mortality rate is returning to pre-coronavirus levels and the racial disparities in who’s most likely to die remain.
The rate for 2022 was 22.3 deaths per 100,000 live births, a significant dip from the surge in 2021 that hit 32.9, according to the report, published Thursday by the CDC’s National Center for Health Statistics. For Black women, the rate decreased the most among racial groups, lowering from 69.9 to 49.5.
Still, the numbers are concerning experts who say, despite the decline, the U.S. maternal mortality rate is far worse than other high-income countries.
“We’re leveling back out to where we were, which is still abysmal,” said Jennie Joseph, a British-trained midwife and founder of Commonsense Childbirth Inc. According to the report, 817 women died due to maternal health causes in 2022, compared with 1,205 in 2021, 861 in 2020, 754 in 2019 and 658 in 2018.
Without another year of data, it’s hard to draw any conclusions about whether 2022’s dip truly indicates a nationwide trend toward a steady decline in the number of deaths per year. It is possible, experts say, that some of the practices being put in place — like greater use of midwives and doulas and increased awareness about systemic racism — could be starting to scratch the surface of widespread impact. But, most experts speculate that the trends in the last few years are COVID-related, and that we’re now starting to see a return to the rates that persisted before the virus devastated communities across the country.
Without another year of data to show the true, long-term trajectory of the maternal mortality rate, officials are hesitant to make assumptions and worry that this slight dip could convince folks that the crisis is less dire than it is. More years of data will offer more context and reveal additional patterns.
“I’m hoping 2021 is the worst we will see,” said Dr. Ndidiamaka Amutah-Onukagha, the founder and director of the MOTHER Lab at Tufts University, whose mission is to eliminate the racial disparities Black women face in childbirth. There’s a lot that will be affecting the statistics we see in the years to come, she said, from the 2022 U.S. Supreme Court decision that reversed the constitutional right to an abortion to rural hospital closures and OB-GYN shortages.
Black women remain at least three times as likely to die due to pregnancy related causes compared to white women.
Nationwide trends are hard to pin down, said Tiffany Green, an associate professor at the University of Wisconsin-Madison focused on population health and obstetrics and gynecology. Conditions vary so much from state to state and the data tends to be relatively small. But what we know, she said, is that heart-related issues are the main cause of death related to pregnancy, childbirth, and postpartum.
“There needs to be a big shift in how we talk about this,” said Green. A lot more focus should be on how we address preeclampsia and other disorders affecting the heart. Other top causes include mental health-related issues, like depression and substance use. By effectively addressing those underlying causes, we could see a significant reduction in deaths, she said.
For now, many experts are continuing to research and provide care for the families they work with without drawing too many conclusions about the most recently released data.
“We don’t know until the next set of numbers come out,” said Joseph, the midwife. Still, “this death is preventable no matter which way we count them.”
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