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The US has the highest maternal mortality rate among developed countries, and 84% of those pregnancy-related deaths are preventable, according to a new report by the Centers for Disease Control and Prevention (CDC).
These shocking statistics can be difficult to digest, especially since the US spends more on healthcare per capita than other industrialized nations.
What is causing these preventable deaths? And how are Latinas impacted?
Let’s unpack the report’s findings and implications.
What is a Preventable Pregnancy-Related Death?
A pregnancy-related death is a fatality that occurs during pregnancy, delivery, and up to a year postpartum due to a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition caused by the effects of pregnancy, according to the report.
A pregnancy-related death was considered preventable in the report if there was at least some chance of the death being averted by one or more reasonable changes to patient, community, provider, facility, and/or system factors.
For example, changes to provider factors could include a more diverse nursing staff, which has been shown to improve maternal health for Latinas and all women.
Timing of Pregnancy-Related Deaths
The CDC analyzed data on 1,018 pregnancy-related deaths among residents of 36 states from 2017–2019, according to the report.
Among deaths for which timing in relation to pregnancy is known:
- Approximately 22% of deaths occurred during pregnancy.
- 25% occurred on the day of delivery (within 24 hours of the end of pregnancy) or within a week after delivery.
- 23% occurred seven to 42 days postpartum.
- 30% occurred in the late postpartum period (43–365 days postpartum).
In other words, nearly half of pregnancy-related deaths occurred during pregnancy and within seven days after delivery, and a little more than half of deaths occurred seven to 365 days postpartum.
Causes of Pregnancy-Related Deaths
According to the report, the six most frequent underlying causes of pregnancy-related deaths included:
- Mental health conditions (22.7%)
- Hemorrhage (13.7%)
- Cardiac and coronary conditions (12.8%)
- Infection (9.2%)
- Thrombotic embolism (8.7%)
- Cardiomyopathy (8.5%)
When it came to race/ethnicity, the leading cause of pregnancy-related death varied.
For Latinas, mental health conditions were the leading underlying cause of death.
Mental health conditions in the report included suicide, substance use disorder, and overdose/poisoning related to substance use disorder.
These results indicate that Latinas and all women could benefit from more mental healthcare before, during, and after pregnancy.
In fact, Latinas and other people of color often have untreated and unaddressed mental illnesses, due to a variety of reasons, such as a stigma against mental illness, distrust in mental health services, or lack of access to treatment.
“Among US adults with mental disorders, racial/ethnic minorities are only half as likely as Whites to get treatment; they are also more likely to drop out before completing their treatment,” according to an article from the National Institute on Minority Health and Health Disparities.
Maternal Mortality in the US
Clearly, based on the report’s findings, more work needs to be done in various areas to prevent pregnancy-related deaths in the US.
“In the United States of America, in the 21st century, being pregnant and giving birth should not carry such great risk. And yet, before, during, and after childbirth, women in our country are dying at a higher rate from pregnancy-related causes than in any other developed nation,” Vice President Kamala Harris wrote in a letter in the White House Blueprint for Addressing the Maternal Health Crisis.
Historically, Black women have been disproportionately affected by pregnancy-related deaths, having nearly three times higher maternal mortality rates than White women.
Other women of color, such as Latinas, are also affected, especially since the emergence of COVID-19.
Prior to the COVID-19 pandemic (2007-2016), Latinas had a comparable maternal mortality rate to White women, according to the Kaiser Family Foundation.
But from 2018-March 2020, when the pandemic began, to April-December 2020, the Latina maternal mortality rate rose an alarming 74.2%, according to a June 2022 study.
In comparison, White women’s maternal mortality rate rose just 17.2% during the same time.
The US also does not fare well in maternal morbidity.
“The disparities go well beyond tragic, unnecessary deaths,” according to The Surgeon General’s Call to Action to Improve Maternal Health. “Each year, thousands of women experience severe maternal morbidity—unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to their health. These health outcomes create lasting burdens that make it more challenging for mothers to live healthy, flourishing lives. Such disparities and outcomes are unacceptable.”
How Can We Improve Maternal Mortality in the US?
Latinas and all women deserve better maternal health outcomes.
Policies at the federal, state, and hospital level can help.
For example, the CDC points to addressing barriers to care, such as wider access to insurance coverage, and improving prenatal care and follow-up after pregnancy.
Improving coordination among healthcare providers, such as primary care providers and ob-gyns, can also help reduce maternal mortality.
Diversifying the healthcare workforce and increasing access to culturally competent mental healthcare is also important.
More ways to improve maternal health are outlined in the White House Blueprint for Addressing the Maternal Health Crisis.
“The Biden-Harris Administration is committed to cutting the rates of maternal mortality and morbidity, reducing the disparities in maternal health outcomes, and improving the overall experience of pregnancy, birth, and postpartum for people across the country. Our vision for the future is that the United States will be considered the best country in the world to have a baby,” according to the Blueprint.
The bottom line? Everyone can help prevent pregnancy-related deaths, according to the CDC.
“It is critical for all healthcare professionals to ask whether their patient is pregnant or has been pregnant in the last year to inform diagnosis and treatment decisions. Healthcare systems, communities, families, and other support systems need to be aware of the serious pregnancy-related complications that can happen during and after pregnancy. Listen to the concerns of people who are pregnant and have been pregnant during the last year and help them get the care they need,” the CDC stated.
You Can Help Push for Health Equity for Latinas
You can promote health equity by selecting your county and getting a Health Equity Report Card by Salud America! at UT Health San Antonio.
In your report card, you will see maps, data, and gauges to compare health equity issues, including access to healthcare and social vulnerability to COVID-19, to the rest of your state and nation.
You can email your Health Equity Report Card to local leaders to stimulate community change. Use the data in your materials or share on social media to raise awareness.