According to the latest data on maternal mortality, an increasing number of American women die during pregnancy or shortly after giving birth.
In 2021, were 32.9 deaths per 100,000 live birthsThat compared to 23.8 per 100,000 in 2020 and 20.1 in 2019, the National Center for Health Statistics reported March 16. American rates are too high of other high-income countries. The total number of US maternal deaths is set to increase from 861 in 2020 to 1,205 in 2021.
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There remains a wide disparity in maternal mortality rates for black women, 69.9 deaths per 100,000 live births, compared with 26.6 per 100,000 for white women. Several social determinants of health underlie this difference, including difference in quality of care that black women receive before, during, and after pregnancy.
The reasons behind the increase for 2021 are not discussed in the NCHS report. But COVID-19 contributed to a quarter of maternal deaths In 2020 and 2021, the US Government Accountability Office reported in October. The pandemic also contributed to the mortality disparity between black and white women, the GAO found, worsening existing structural disparities that lead to issues such as Barriers to Accessing Health Care ,Sn: 4/10/20,
Maternal deaths recorded by the NCHS report are those that occur during pregnancy or within 42 days after the end of pregnancy, “from any cause related to or aggravated by the pregnancy or its management.” These causes include bleeding, infection, and hypertensive disorders such as eclampsia.
The report does not include deaths after 42 days and up to the first year after birth. But 30 percent of pregnancy-related deaths occurs during this period, the US Centers for Disease Control and Prevention reported in September from an analysis from 2017 to 2019.
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“We really need to be able to care for our new moms beyond the six-week period,” says maternal fetal medicine specialist Cynthia Gyampy-Bannerman, chair of the department of obstetrics, gynecology and reproductive science at the University of California, San Diego. ” School of medicine
One effort to expand coverage into the year after birth is through Medicaid insurance, which paid for 42 percent of US births in 2020. Rescue Plan Act 2021.
Maternal mortality also does not include maternal deaths due to human slaughter. In 2018 and 2019, murder was the leading cause of death Causes such as bleeding accounted for more than twice as many deaths during pregnancy or within 42 days after the end of pregnancy, researchers report. obstetrics and gynecology In 2021. Studies have found that in most of these murder cases, an intimate partner is the killer, most often using a gun. Pregnant women are at higher risk of homicide than non-pregnant women of reproductive age.
Suicide is also a leading cause of death during pregnancy and one year after birth, but is not included in maternal mortality.
Gymfi-Bannerman says management of pregnancy complications such as hemorrhaging and blood pressure disorders has improved. implementing care bundles for these and other complications, which are similar to medical checklists can reduce maternal mortality,
But since gun violence and poor maternal mental health “are also causing maternal mortality,” Gymfi-Bannerman says, it’s important to address these issues as well.