NEWS

Majority of Pregnancy-Related Deaths Are Preventable, According to CDC Report

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Key Takeaways

  • A new report from the Centers for Disease Control and Prevention (CDC) found that four in five maternal deaths in America were preventable.
  • This report looked at maternal mortality during pregnancy, childbirth, and for the entire first year postpartum.
  • Methods for preventing maternal deaths include improving patient health, increasing community support, and addressing systemic inequities

A sobering new report from the CDC has found the majority of maternal deaths in the U.S. are preventable. According to the September 2022 report, four out of five maternal deaths (80%) could have been prevented by improvements to maternal healthcare, better access to high-quality care, and greater awareness of the disparities in healthcare that lead to these preventable deaths.

The U.S. has one of the highest maternal mortality rates among developed countries, and during the pandemic, deaths among birthing parents increased. This CDC report highlights issues that have led to this growing problem, but it also offers hope for change.

“The most important takeaway from this report is the high rate of preventability,” says Afshan B. Hameed, MD, an OB/GYN and medical director of obstetrics at UCI Health. “80% of the deaths could have been prevented (i.e. four out of five people who died could have been alive). It brings focus on preventive strategies and access to medical care after pregnancy.”

How Is Maternal Mortality Defined?

When you think of a term like “maternal mortality,” you likely think of a birthing person dying during childbirth. But the definition of maternal mortality, as offered by the CDC report, actually encompasses a larger span of time—including pregnancy, childbirth, and the first year postpartum.

The CDC report breaks down death by these different time periods, finding that 22% of deaths happened during pregnancy and 25% occurred during delivery or the week after. However, what’s perhaps most notable here is the vast majority of deaths—53%—occurred during the postpartum period.

Kiranpreet Chawla, MD, an OB/GYN at the University of Maryland Medical Center and assistant professor at the University of Maryland School of Medicine, thinks it’s commendable the CDC has included deaths after childbirth in their definition of maternal mortality. Dr. Chawla notes this is a change. In the past, maternal mortality was defined as a death or complication that occurred during pregnancy or during the first 6 weeks postpartum.

“I personally find it to be a true step forward by the CDC to expand the definition to a year after the end of a pregnancy,” she says. “The previous timeline of six weeks was far too short when we know that multiple pregnancy conditions can have long-term or permanent impacts on an individual.”

What Are the Top Causes of Maternal Mortality?

This report not only looked at the percentages of deaths that were preventable, but also what was causing those deaths, and how these causes differed based on race and ethnicity.

The leading cause of death, according to the report, was health conditions among birthing people (23%), which included suicide and overdoses due to substance abuse disorders. Other top causes of death included hemorrhaging (14%) and cardiac conditions (13%). Additionally, 9% of deaths were due to infections, blood clots, or cardiomyopathy (a hereditary condition affecting the heart muscle). Pregnancy-related high blood pressure disorders made up 7% of deaths.

These disorders affected different races and ethnicities in specific ways. The CDC report found cardiac conditions were the top cause of death in pregnancy among Black parents. Mental health conditions were most likely to affect Hispanic people and non-Hispanic White people. Among Asian Americans, hemorrhaging was a leading cause of death. Both mental health conditions and hemorrhaging were the most common causes of death for American Indian or Alaska Native (AI/AN) parents, comprising about 50% of known causes.

How Race and Ethnicity Factor Into Maternal Mortality

This new report brings to light the way that race affects the health and well-being of birthing parents. Understanding and acknowledging this reality is imperative when it comes to addressing the inequities inherent in healthcare, says Dr. Chawla. “Across health care, we need to do better caring for all people, regardless of race,” she says. “This requires identifying causes of disparities and meaningful ways to close the gaps.”

Across health care, we need to do better caring for all people, regardless of race. This requires identifying causes of disparities and meaningful ways to close the gaps.

KIRANPREET CHAWLA, MD

Racial inequities, especially among Black parents, are an ongoing contributor to maternal mortality. For example, a 2020 CDC report found that maternal mortality rates were highest among Black parents, at 55.3 deaths for every 100,000 births. This rate was 2.9 times higher than the rate among White parents.

As maternal mortality rates and health inequities have crept up during the pandemic, so have the rates among Black parents. A report from the Michigan Statewide Collaborative examining the number of pregnant people getting severely ill due to a COVID-19 infection found that a whopping 43% were Black. This was twice the rate of White parents, even after adjusting for underlying conditions such as diabetes and obesity.

Hemamalini Pilla, MD, an OB/GYN and medical director at Obstetrics and Gynecology of Southeast Houston, part of Pediatrix Medical Group, says although being a person of color isn’t what causes these increased rates, communities of color are disproportionately affected by racism, and racism contributes to severe pregnancy outcomes.

“Social determinants of health are well-known to contribute to this increased risk in minority populations like inadequate and unsafe living conditions, low education, unemployment, chronic stress and lack of adequate health care access,” Dr. Pilla describes.

How Can Pregnancy-Related Deaths Be Prevented?

The CDC report defines preventable deaths as deaths that had a chance of being avoided by “reasonable changes” to the birthing parent, community, healthcare provider, provider facility, or system. That means it's vital to address factors like barriers to quality healthcare, inadequate support systems, as well as biases from medical providers who care for new parents. It also means we need to confront systemic roadblocks, such as ensuring that all expectant parents have access to health insurance.

Dr. Chawla stresses the importance of holding healthcare providers accountable when it comes to aspects like racial bias. This can be accomplished by creating a more diverse healthcare system so parents can be tended to by people they feel more comfortable with.

“There is understandable mistrust of the health care system by many patients who are also people of color,” she says. “If we can diversify our nurses and other healthcare providers, we can try to bridge that gap.”

It's also vital high-quality healthcare be available to anyone who needs it, Dr. Pilla emphasizes. “Regular health care before, during, and after pregnancy will help the provider to identify conditions that can lead to serious morbidity and mortality,” she says.

Regular health care before, during, and after pregnancy will help the provider to identify conditions that can lead to serious morbidity and mortality.

HEMAMALINI PILLA, MD

The earlier pregnant people start receiving prenatal care, the better, she says. Educating parents prenatally on healthy lifestyle choices such as diet, exercise, vaccinations, and cessation of smoking and alcohol use, can help ensure healthy pregnancy outcomes, Dr. Pilla describes.

Moreover, making sure parents have access to quality healthcare during the postpartum period, is imperative, as the CDC report underscores. “Advocacy at the governmental level to extend health care insurance to the underinsured for one year after delivery will decrease maternal morbidity and mortality,” says Dr. Pilla.

Angela D. Aina, co-founding executive director of Black Mamas Matter Alliance (BMMA), says when it comes to ensuring accessible and lifesaving care to minority mothers, it’s important to address the systemic changes that urgently need to happen. But it’s also important to think locally.

“The Black Mamas Matter Alliance strongly advocates for policy changes that will invest funds towards community-based resources and organizations that can offer services like midwifery, doula care, group prenatal care, child care, education, support, accompaniment, and more,” says Aina. “At BMMA, we truly believe that the best, most impactful changes often happen at the local level.”

What This Means For You

It can be distressing to consider the fact that maternal mortality is still such a glaring issue in the U.S., even in 2022. But this new CDC report brings light to the fact that the majority of these deaths are preventable. There are things that can be done so that all new parents get the high quality healthcare they need as they bring new life into the world.

9 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  7. Michigan Medicine. COVID-19 in Pregnancy: Studying racial disparities and adverse birth outcomes.

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By Wendy Wisner
Wendy Wisner is a lactation consultant and writer covering maternal/child health, parenting, general health and wellness, and mental health. She has worked with breastfeeding parents for over a decade, and is a mom to two boys.