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A University of Washington study released Monday shows maternal mortality rates more than doubled in some states between 1999 and 2019, with sharp increases for some racial and ethnic groups.
Published in the Journal for the American Medical Association, the report showed five states with a 93% increase in Black maternal mortality rates: Louisiana, New Jersey, Georgia, Arkansas and Texas.
Nationally, the maternal mortality rate is two to four times higher for the non-Hispanic Black population than non-Hispanic whites, the research showed.
Last month, Tori Bowie, a three-time Olympic medalist in track and field died while undergoing childbirth in her home, according to the Orange County Medical Examiner Office in Florida. Her unborn child did not survive.
According to Kimberly Holland, Bowie’s agent, Bowie “didn’t trust hospitals.”
“She wanted to make sure that the baby was going to be okay with her being in control,” Holland said.
According to the Centers for Disease Control and Prevention, Black women are three times more likely than White women to die from pregnancy-related causes.
“There are systemic barriers that we face in regard to racism, sexism and income inequality, and that shows up in our healthcare system,” said Dr. Regina Davis Moss, president and CEO of In Our Own Voice: National Black Women’s Reproductive Justice Agenda.
The study assembled information about people who died while pregnant or up to one year afterward. Causes often include hemorrhage, heart conditions, infections, and high blood pressure, all of which can develop even months post-delivery, because of the ways the body changes and reacts to carrying and birthing a baby.
Dr. Greg Roth, a cardiologist and associate professor of medicine at the University of Washington, said the study did not evaluate potential causes of deaths, but the university intends to examine those subjects in follow-up studies. He said based on his own experience in medicine, the deaths often point to the conditions in which people live and work.
The map of maternal mortality looks like the map of social determinants of health,” Roth said. “Regardless of what the political situation is in a particular state, social determinants of health are going to drive maternal health.”
Studies over the past decade or more have often revealed large disparities between Black and white populations in maternal mortality rates, particularly in the South, where poor access to health care, gaps in insurance coverage and other social supports have historically been associated with high mortality rates.
“One of the key messages here is that we have to focus on women’s health before, during, at the time of delivery, and after pregnancy,” Roth said. “That sounds a lot like easily accessed, universal, low-cost primary care along with high-quality obstetrician care.”
Recent data in Mississippi, where a near-total abortion ban is in place, shows those trends are worsening. Doctors are expressing concern and confusion about reproductive health care laws in states like Louisiana, which is limiting essential care.
Researchers also noted large increases of more than 162% among Indigenous people in Florida, Kansas, Illinois, Rhode Island, and Wisconsin, where those spikes have not been highlighted as often. The data showed both physical conditions like hemorrhages and mental health were major contributors to their pregnancy-related deaths.
In the Asian, Native Hawaiian or Other Pacific Islander category, five states saw an increase of over 83%: Kansas, Illinois, Missouri, Michigan, and Georgia.
Pregnant Hispanic people or those who’d recently given birth in Indiana, Minnesota, Georgia, Tennessee, and Illinois died more than twice as often in 2019 than two decades before.
Dr. Allison Bryant, a high-risk obstetrician-gynecologist for Mass General Brigham in Massachusetts, said the data confirms much of what was already known about trends, but it is even more important now that 15 states have near-total bans on abortion.
People who become pregnant unintentionally and can’t get an abortion may become more likely to overdose or die by suicide, particularly those with existing addiction or mental health issues.
Additionally, she said more pregnancies may be carried to term that aren’t healthy and could cause death rates to rise.
Nationally, the maternal mortality rate is two to four times higher for the non-Hispanic Black population than non-Hispanic whites, the research showed.
According to the study, the states of Oregon, Hawaii, Colorado, Illinois, Wisconsin, Delaware, Vermont, and Rhode Island had lower 2019 maternal mortality rates across all racial and ethnic groups, “suggesting that either underlying risk factors that drive maternal deaths are lower in these states, or that prevention efforts have had some success in these locations.”
This article was originally published here.
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