Maternal deaths across the United States more than doubled over the course of two decades, and the tragedy unfolded unequally.
Black mothers died at the nation’s highest rates, while the largest increases in deaths were found in American Indian and Native Alaskan mothers. And some states – and racial or ethnic groups within them – fared worse than others.
The findings were laid out in a study published Monday in the Journal of the American Medical Association. Researchers looked at maternal deaths between 1999 and 2019 – but not the pandemic spike – for every state and five racial and ethnic groups.
Among wealthy nations, the U.S. has the highest rate of maternal mortality, which is defined as a death during pregnancy or up to a year afterward. Common causes include excessive bleeding, infection, heart disease, suicide and drug overdose.
Researchers at Mass General Brigham and the Institute for Health Metrics and Evaluation at the University of Washington started with national vital statistics data on deaths and live births. They then used a modeling process to estimate maternal mortality out of every 100,000 live births.
The study showed high rates of maternal mortality aren’t confined to the South but also extend to regions like the Midwest and states such as Wyoming and Montana, which had high rates for multiple racial and ethnic groups in 2019.
Researchers also found dramatic jumps when they compared maternal mortality in the first decade of the study to the second, and identified the five states with the largest increases between those decades. Those increases exceeded 93% for Black mothers in Arkansas, Georgia, Louisiana, New Jersey and Texas and exceeded 100% for other racial and ethnic groups in some states.
Experts pointed to how, compared with other wealthy nations, the U.S. underinvests in things like social services, primary care and mental health.
In Arkansas, Black women are twice as likely to have pregnancy-associated deaths as white women, according to a 2021 state report.
Rates among Black women have long been the worst in the nation, and the problem affects people of all socioeconomic backgrounds.