Most Pregnancy-Related Deaths in the US Are Preventable

More than 80% of pregnancy-related deaths in the US are preventable, a new report suggests. Prevention, among other things, could include widening access to insurance coverage.

In the US, 84% of deaths during pregnancy or one year after giving birth are preventable, according to the report published by the Centers for Disease Control and Prevention (CDC).

The report reviewed 2017-2019 data on pregnancy-related deaths in 36 US states from Maternal Mortality Review Committees (MMRCs). Out of 1,018 deaths that occurred during the period, 839 were preventable.

Leading cause — mental conditions

The report reveals that almost one in four deaths (22%) occurred during pregnancy, and 25% occurred on the day of delivery or within seven days after. More than half (53%) of deaths happened between 7 days to 1 year after pregnancy.

The leading cause, accounting for 23% of pregnancy-related deaths, were mental conditions, including deaths to suicide and overdose or poisoning related to substance use disorder.

One in seven (14%) of pregnancy-related deaths were caused by excessive bleeding (hemorrhage), while cardiac and coronary conditions resulted in 13% of deaths.

Other causes of pregnancy-related deaths are infection (9%), thrombotic embolism, which is a type of blood clot (9%), heart muscle disease cardiomyopathy (9%), and hypertensive disorders of pregnancy related to high blood pressure (7%).

Mental health conditions were the leading underlying cause of pregnancy-related deaths among Hispanic and non-Hispanic White people. In contrast, cardiac and coronary conditions were the leading cause among non-Hispanic Black people. For non-Hispanic Asian people, the leading cause of pregnancy-related deaths was hemorrhage.

“The majority of pregnancy-related deaths were preventable, highlighting the need for quality improvement initiatives in states, hospitals, and communities that ensure all people who are pregnant or postpartum get the right care at the right time,” said Wanda Barfield, M.D., M.P.H., director of CDC’s Division of Reproductive Health at the National Center for Chronic Disease Prevention and Health Promotion in a press release.

Maternal mortality is increasing in the US

A recent study demonstrated that between 2019 and 2020, there was a 33.3% increase in US maternal mortality from 18.8 deaths per 100 000 live births before the pandemic to 25.1 deaths per 100 000 live births during the pandemic. The most significant rise was among Hispanic and non-Hispanic Black people.

The maternal mortality rate is much higher in the US than in other high-income countries, for example, nearly three times higher than in France, Canada, or the UK. While maternal mortality has decreased by more than 40 percent globally since 1990, the US was the only developed country seeing the increase.

To prevent maternal deaths, MMRCs recommend widening access to insurance coverage to improve prenatal care initiation and follow-up after pregnancy, providing opportunities to prevent barriers to transportation to care, and the need for systems of referral and coordination.

“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 report says.

Resources:

CDC. Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 2017–2019.

CDC. Four in 5 pregnancy-related deaths in the U.S. are preventable.

JAMA Network. All-Cause Maternal Mortality in the US Before vs During the COVID-19 Pandemic.

Wilson Center. What Explains the United States’ Dismal Maternal Mortality Rates?

The Century Foundation. The Worsening U.S. Maternal Health Crisis in Three Graphs.

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