Maternal Deaths drop- except for Black women
New data released by the Centers for Disease Control and Prevention show maternal death rates are improving across all racial and ethnic groups, except for Black women.1,2 Here we explore what this means, why Black women are at higher risk, and how doula services can be a part of the solution.
Graph: Axios
Important Terms to Know
Maternal Death
Maternal deaths are deaths that are caused or aggravated by pregnancy and that occur during or within 42 days of the end of a pregnancy, regardless of whether the pregnancy ends in a live birth or a loss.The Centers for Disease Control and Prevention collects data on maternal deaths and releases reports on current trends in the US. This report is used to inform policies, programs, and efforts to improve maternal health for birthing people.
Maternal Mortality Rate
The number of maternal deaths per 100,000 live births (as defined above, maternal death broadly includes those that do not end in live births but Maternal Mortality Rate excludes those).3
Pregnancy-Related Death
“The death of a woman while pregnant or within 1 year of the end of a pregnancy—regardless of the outcome, duration, or site of the pregnancy—from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.”4
These are maternal deaths that occur because of or are directly related to pregnancy, such as health complications. These are maternal deaths that are used when calculating Maternal Mortality Rates. Pregnancy-related deaths are counted up to 1 year after birth, but Maternal Mortality Rates only include those that occur within 42 days after birth.
Pregnancy-Associated Death
“Maternal death that is attributable to a condition that is unaffected by the pregnancy and occurs within 1 year of the pregnancy”4
These are maternal deaths that occur during or within one year of pregnancy, but are not directly related. Examples of pregnancy-associated deaths are homicide and drug-related overdoses. Pregnancy-associated deaths are not considered when calculating Maternal Mortality Rates.
What happened to maternal mortality in 2023?
Maternal deaths in the US dropped overall, meaning less people died from pregnancy-related causes. Even though fewer deaths happened, disparities grew. The pregnancy-related death rate for Black women is more than 3 times the rate of any other racial or ethnic group, at 50.3 deaths per 100,000 live births. Also, death rates for all other groups decreased in 2023, while those for Black women remained the same.
Why are Black mothers more affected by maternal deaths?
Experts say there are several reasons why maternal death is higher in Black women than in any other group.5
Some of these reasons include:
Lack of access to primary care
Lack of representation in the healthcare system
Access to prenatal and postpartum care
Lasting impact of the COVID-19 pandemic
Health Insurance coverage
Racism within the health care system
There are many complex factors that contribute to worse health outcomes among Black birthing people, but these are some of the most widely reported.
What can be done to improve maternal mortality?
Efforts are being made across advocacy organizations, non-profits, and government agencies to improve the state of maternal health in the US, including:
Expanding access to coverage through Medicaid expansions
State Medicaid plans incorporating a wider range of services (like doulas!) and education
Community engagement efforts
Lifting up and increasing diverse voices in the maternal health workforce
Increased support for maternal mental health and substance use
Improving data collection
These strategies could improve care for birthing people across the United States, increasing access and quality of care while improving representation and diversifying care teams.5
How can doulas help?
Doula services have been shown to improve outcomes for both birthing people and their newborns.5 The support services doulas provide can be vital to provide all people the birthing experience they deserve. The integration of doula services into healthcare systems has been a vital strategy many states are implementing to ensure care teams can provide culturally-centered care and honor the birthing person’s needs and wants before, during, and after birth.
Sources