The maternal death rate across the United States rose significantly in 2021 amid the COVID-19 pandemic, according to a new report from the National Center for Health Statistics at the Centers for Disease Control and Prevention (CDC).
The report, published on March 15, shows maternal mortality rates—which are based on the number of deaths per 100,000 live births—surged by nearly 40 percent during 2021 compared to a year prior.
In total, 1,205 women died of maternal causes across the nation in 2021 compared with 861 in 2020 and 754 in 2019, according to the report, which is based on data from the National Vital Statistics System.
Compared to 2019, the year before the pandemic began, mortality rates increased by nearly 60 percent in 2021.
Overall, the maternal mortality rate for 2021 was 32.9 deaths per 100,000 live births—the highest since 1965—compared with a rate of 23.8 in 2020 and 20.1 in 2019.
The maternal mortality rate in the United States is over three times more than that of most other high-income countries, according to a study by the Commonwealth Fund.
The CDC defines maternal death as the death of a woman while pregnant or within 42 days of the end of pregnancy, but excludes deaths from accidental or incidental causes.
COVID-19 Contributing to Deaths
Additionally, the report found maternal mortality rates among black women were more than twice as high as those of white women.
In 2021, the maternal mortality rate for black women was 69.9 deaths per 100,000 live births, which is 2.6 times the rate for white women at 26.6 deaths per 100,000, although the increases from 2020 to 2021 for all races and Hispanic-origin groups were significant.
The report also showed that rates increased with the mother’s age.
Rates in 2021 were 20.4 deaths per 100,000 live births for women under 25 and 31.3 for those 25 to 39. For women ages 40 and older, it was 138.5.
That means the rate for women 40 and over was 6.8 times higher than the rate for women under age 25, according to the report, which noted that differences in the rates between age groups were “significant.”
Experts believe the increased rate is largely associated with the pandemic.
An October report from the U.S. Government Accountability Office found that COVID-19 was a contributing factor in 25 percent of maternal deaths in 2020 and 2021 (pdf).
Access to Health Care, Social Barriers
Dr. Elizabeth Cherot, chief medical and health officer for the infant and maternal health nonprofit March of Dimes, told CNN that the pandemic had an impact on maternal mortality rates in 2020 and 2021.
“This is sort of my reflection on this time period, COVID-19, and pregnancy. Women were at increased risk for morbidity and mortality from COVID. And that actually has been well-proven in some studies, showing increased risks of death, but also being ventilated in the intensive care unit, preeclampsia, and blood clots, all of those things increasing a risk of morbidity and mortality,” Cherot added.
However, multiple other factors such as a decline in access to insurance coverage amid rising inflation and other structural and systemic issues may also be contributing to the rise.
About 6.9 million women in the United States have little or no access to maternal health care, according to March of Dimes.
“We have to address the social factors that either are barriers to accessing care or that make your medical conditions worse coming into the pregnancy,” Dr. Veronica Gillispie-Bell, an OB-GYN at Ochsner Health in Louisiana, told NPR. “This is not just about doctors in the hospital.”
Additional CDC data published in September found that of the 1,018 pregnancy-related deaths recorded among residents of 36 states from 2017–2019, 84 percent could have been prevented.
Last year the Biden administration released the “Blueprint for Addressing the Maternal Health Crisis,” dubbed a “whole-of-government approach” to tackling maternal mortality and morbidity.
Under that plan, the administration called on Congress to expand Medicaid coverage for women 12 months postpartum and bolster economic and social support for women during and after pregnancy.
Biden’s fiscal year 2023 budget also included $470 million in initiatives aimed at reducing maternal mortality and morbidity rates, including health initiatives in rural communities and “implicit bias” training for health care providers.