Maternal Death Rates Soared During Pandemic—Especially Among Black And Hispanic Women, Study Finds

Topline

Maternal deaths soared during the Covid-19 pandemic, particularly among Black and Hispanic women, according to a study published in JAMA Network Open on Tuesday, underscoring the vast inequalities that worsened during the crisis and the unique health issues the virus posed to pregnant people.

Maternal mortality rates increased during the pandemic.

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Key Facts

The number of maternal deaths in the U.S. jumped by a third (33%) after March 2020— roughly the start of the Covid-19 pandemic—compared to the two years before, according to an analysis of data from the National Center for Health Statistics (NCHS).

This disproportionately affected Black and Hispanic women, the researchers found, where deaths respectively increased by 40% and 74%.

In the same time period, maternal deaths among white women increased by 17%.

Health records that acknowledged “indirect causes” as an underlying cause of death jumped by 57% during the time period, the researchers found, with the number of these that listed “other viral diseases” soaring nearly 2,400%, diseases of the respiratory system nearly 120% and diseases of the circulatory system 72%.

Among direct causes, which increased nearly 28%, records noting diabetes during pregnancy almost doubled (96%), while those noting blood pressure disorders and other pregnancy-related conditions each increased by 39% and 48%.

While no records exclusively identified Covid-19 as the cause of death, many identified it as a secondary cause, though again this was not evenly distributed, with rates highest among Hispanic women (32.1%), followed by Black (12.9%) and white (7.3%) women.

What We Don’t Know

What caused the changes in maternal death during the pandemic. The increasing number of maternal deaths during the pandemic could be attributed to a rise in Covid infections, other health conditions exacerbated by the pandemic or the disruptions to healthcare, the researchers said. They note this was not possible to discern from the data available, particularly as a large number of records listed nonspecific causes of maternal death and some partitioned data into very small categories.

What To Watch For

Increasing disparities. While the study highlights the relative increase in maternal mortality during the early stages of the pandemic, it’s important to note the large disparities in maternal death between racial and ethnic groups that already exist. According to the researchers, the pre-pandemic death rate among white women is nearly 3 women per 100,000 live births. Among Hispanic women, this was nearly 9 per 100,000. Rates were highest for Black women, around 17 per 100,000. With the Supreme Court overturning Roe v. Wade and threatening access to safe and legal abortion across large parts of the country, these rates could increase, as the decision is expected to have a disproportionate impact on Black women and other women of color.

Big Number

23%. That’s the estimated increase in excess deaths during the time period considered by this study. Excess deaths are the number of deaths beyond what would be expected given previous data and can help provide a more holistic picture of the pandemic’s impact than recorded Covid deaths alone. The maternal mortality increase identified is significantly higher than this, though when stratified for race and ethnicity it is actually lower among white women.

Key Background

The study adds to a well-established body of research that underscores the disproportionate rates of disease and death faced by Black and Hispanic people in America, particularly women. Transgender men and non-binary people, who can become pregnant but were not considered by this study, also face unique barriers to accessing healthcare and suffer from significant health disparities across multiple areas. These inequalities were magnified during the Covid-19 pandemic. Compared to white people, American Indian or Alaska Native, Black and Hispanic people have been more likely to test positive for Covid, at least twice as likely to be hospitalized with it and around twice as likely to die with the disease, according to CDC data. Pregnant people have also faced unique challenges during the pandemic, including interruptions to healthcare and usual support networks. Research consistently shows that pregnant people infected with Covid are at much higher risk of serious disease and death, far more likely to give birth early and are more likely to experience serious complications. Vaccination, a proven safe and effective way of dramatically cutting this risk, has low uptake among this group, partly due to the prevalence of false and misleading information about the shots.