Two studies show that maternal mortality in the US dramatically increased during the covid-19 pandemic and was especially severe among racial and ethnic minorities and in rural areas and small cities.12
The US already has the worst maternal mortality rate among industrialised countries. The World Health Organization defines maternal mortality as a death during pregnancy or within 42 days of the end of pregnancy from any cause related to or aggravated by pregnancy or its management.
Before the pandemic the US ranked last of 10 industrial countries, with 17.4 deaths per 100 000 live births, which compares with 1.7 in New Zealand, 3.2 in Germany, 4.8 in Australia, and 6.5 in the UK.3
The new study from the US Centers for Disease Control and Prevention showed that, in 2021, there were 1205 deaths from maternal causes in the US, up from 861 in 2020—a 40% increase—and 754 in 2019.1 The maternal mortality rate for 2021 was 32.9 deaths per 100 000 live births, up from 23.8 in 2020 and 20.1 in 2019.
Maternal mortality rose from 2020 to 2021 in all racial and ethnic groups. It was much worse in black groups, with 69.9 deaths per 100 000 live births, more than two and a half times the rate in white groups (26.6). Maternal mortality rates also increased in all age groups from 2018 (before the pandemic) to 2021. Among under 25s the rate increased from 10.6 deaths per 100 000 live births in 2018 to 20.4 in 2021. In the 25-39 years age group the rate increased from 16.6 to 31.3, and among those aged 40 or over the rate rose from 81.9 to 138.5.
Most of the people who died in pregnancy were not vaccinated against covid-19. It was not until August 2021 that vaccinations were recommended for pregnant women.
A study from the Schools of Public Health at the University of Maryland and Boston University looked at pregnancy related deaths that occurred up to one year after the end of pregnancy. It found that pregnancy related deaths were significantly higher in 2021, at 45.5 per 100 000 live births, than during the pandemic in 2020 (36.7 deaths per 100 000 live births) and before the pandemic (29.0 per 100 000 live births).2
The researchers said that pregnancy related deaths increased across all race and ethnicity and rural-urban categories in 2021. The largest increase was seen in American Indian/Alaska Native groups. Maternal mortality increased more in small and medium metropolitan areas (39% relative change) and in rural areas (21% relative change) than in large urban areas (15.9% relative change).
A 2022 report on maternal health from the General Accountability Office found that the covid-19 pandemic “exacerbated the effects of social determinants of health—factors such as access to care, transportation, or technology; living environment; and employment—on maternal health disparities. For example, service reductions in public transportation and child care worsened existing barriers to accessing care . . . In addition, the pandemic highlighted the effect racism has on maternal health. For example, physiological changes caused by chronic stress can increase the risk of maternal death, as well as severe illness from covid-19.”4
Hoyert D. Centers for Disease Control and Prevention, National Center for Health Statistics. Maternal mortality in the United States, 2021. Mar 2023. https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.pdf.
Commonwealth Fund. Maternal mortality and maternal care compared to 10 other developed countries. Nov 2020. https://www.commonwealthfund.org/publications/issue-briefs/2020/nov/maternal-mortality-maternity-care-us-compared-10-countries.
US Government Accountability Office. Maternal health outcomes worsened and disparities persisted during the pandemic. Oct 2022. https://www.gao.gov/assets/gao-23-105871.pdf.
The new study from the US Centers for Disease Control and Prevention showed that, in 2021, there were 1205 deaths from maternal causes in the US, up from 861 in 2020—a 40% increase—and 754 in 2019. 1 The maternal mortality rate for 2021 was 32.9 deaths per 100 000 live births, up from 23.8 in 2020 and 20.1 in 2019.Has the pandemic worsened the maternal mortality crisis in the US? ›
Even before the pandemic, the United States had the highest maternal mortality rate of any industrialized nation. The coronavirus worsened an already dire situation, pushing the rate to 32.9 per 100,000 births in 2021 from 20.1 per 100,000 live births in 2019.Is maternal mortality increase during COVID? ›
Mortality rates increased most among racial and ethnic minorities, and the study provides COVID-related context to a new report by the National Center for Health Statistics that indicates that US maternal mortality rates increased by 38 percent in 2021 compared to 2020 rates.How did COVID affect maternal health? ›
The CDC estimated that 102 maternal deaths in 2020 and 401 maternal deaths in 2021 were related to COVID. The overall U.S. maternal mortality rate for 2021 was 32.2 deaths per 100,000 live births compared with a rate of 23.8 in 2020, 20.1 in 2019, and 17.4 in 2018 (Hoyert, 2021; U.S. GAO, 2022).Why has maternal mortality increased in the US? ›
Chronic health conditions, in general, have become a contributing factor, Dr. Rainford explains. “More women than before are coming into pregnancy with a pre-existing condition,” she says.