Most Pregnancy-Related Deaths Could Be Prevented, God Damnit

Among high-income countries, the U.S. has the highest rate of maternal mortality, one that’s more than doubled in the last two decades. This statistic belies stark racial disparities in maternal mortality, which has been attributed to racism and the chronic stress of poverty. The spiraling death rate is part of why recent legislation has pushed for more research into these maternal deaths, to understand why their occurrence has scaled.

Now, new research from the Centers for Disease Control and Prevention has shown that these deaths are highly preventable. Roughly 700 women die from pregnancy-related complications annually, and 60 percent of those deaths—which happen during gestation and up to a year after giving birth— are preventable, according to the study. That means that more than 400 pregnancy-related deaths in the United States could be prevented each year, but are not.

Black women were more than three times as likely to die from pregnancy-related complications than white women, according to the report.

The CDC report found that the leading causes of pregnancy-related death were cardiovascular conditions, infection, and hemorrhage. Although conversations around maternal mortality typically focus on the act of giving birth, most of these deaths—33 percent—happened between a week and a year after birth.
In fact, the lowest percentage—17 percent—happened on the day of delivery. (It’s worth noting that many women experience nonfatal childbirth injuries that are treated as an afterthought by doctors who prioritize the health of the baby.) Thirty-one percent happened during pregnancy, and 19 percent happened within the first week after birth.

The racial disparities are stunning: The rate of pregnancy-related deaths was 13 per 100,000 lives births for white women and 42.8 among black women. It was 32.4 for American Indian and Alaska Native women. These rates are 3.3 and 2.5 times as high as among white women. Somewhat surprisingly, there was no significant racial difference in the preventability of these deaths.

“While maternal deaths are relatively rare, every death is tragic and it often represents a web of missed opportunities,” said Nicole Davis, co-author of the report, in an interview with Stat News. These deaths may be statistically rare, but they are vastly preventable.

The report lays out some possible prevention approaches around improved healthcare access (including upping the number of providers taking Medicaid) and quality (for example, providing better obstetric simulation training). The report also recommends expanding Medicaid coverage for pregnant women to include care one year postpartum. This week, Sen. Cory Booker and Rep. Ayanna Pressley are introducing legislation—the Maximizing Outcomes for Moms through Medicaid Improvement and Enhancement of Services (MOMMIES) Act—to do just that.