Explainer: Maternal death rate continues to increase sharply
By / Mar 24

Maternal death is a tragedy that affects women and their families around the world. In the United States, maternal death rates have been on the rise, with the U.S. having one of the highest maternal mortality rates among developed countries. Recently released federal data reveals that the nation’s maternal death rate rose significantly in 2021, with the rates among Black women more than twice as high as those of white women.

Here is what you should know about maternal death in America.

What is the maternal death rate?

The maternal death rate is the annual number of female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy.

A related concept is “late maternal death,” which is the death of a woman from direct or indirect obstetric causes, more than 42 days but less than one year after termination of pregnancy.

How many maternal deaths occurred in 2021, and what was the rate of maternal death?

In 2021, 1,205 women died of maternal causes in the United States compared with 861 in 2020 and 754 in 2019—an increase of 40%. The maternal mortality rate for 2021 was 32.9 deaths per 100,000 live births, compared with a rate of 23.8 in 2020, and 20.1 in 2019. 

The increases from 2020 to 2021 for all groups were significant. But the maternal mortality rate for Black women, though, was more than twice as high as the rate for white women—69.9 deaths per 100,000 live births.

Rates also increased with maternal age. Rates in 2021 were 20.4 deaths per 100,000 live births for women under age 25, 31.3 for those aged 25–39, and 138.5 for those aged 40 and over. The rate for women aged 40 and over was 6.8 times higher than the rate for women under age 25.

What are the primary causes of maternal death?

The Centers for Disease Control conducted a study in 36 US States over the period 2017–2019. The results showed that the six most frequent underlying causes of pregnancy-related death were:

  • mental health conditions (22.7%)
  • hemorrhage (13.7%)
  • cardiac and coronary conditions (12.8%)
  • infection (9.2%)
  • thrombotic embolism (8.7%)
  • cardiomyopathy (8.5%)

The six causes accounted for over 75% of pregnancy-related deaths during the period of the study.

Leading underlying causes of death varied by race and ethnicity. Cardiac and coronary conditions were the leading underlying cause of pregnancy-related deaths among non-Hispanic Black persons; mental health conditions were the leading underlying cause of death among Hispanic and non-Hispanic White persons; and hemorrhage was the leading underlying cause of death among non-Hispanic Asian persons.

The leading causes of pregnancy-related death among non-Hispanic American Indian or Alaska Native and non-Hispanic Native Hawaiian and other Pacific Islander persons were not ranked because of small population size.

When is maternal death most likely to occur?

The CDC study found that among deaths for which timing in relation to pregnancy is known, approximately 22% of deaths occurred during pregnancy, 25% occurred on the day of delivery (within 24 hours of the end of pregnancy) or within a week after delivery, 23% occurred from 7 to 42 days postpartum, and 30% occurred in the late postpartum period. 

Why are maternal deaths so much higher for Black women?

Black women in the U.S. are two to four times more likely to die from pregnancy-related complications than white women. This racial disparity exists regardless of education level or income. In fact, college-educated Black women have a higher risk of maternal death than white women who did not complete high school. The reasons behind these disparities are complex and multifaceted, but are often attributed to racial disparities in maternal health.

Many women in the U.S. lack access to affordable and quality healthcare, particularly in rural areas and communities of color. This can lead to delays in seeking care or not receiving necessary care, which can increase the risk of maternal death. In addition, many women lack access to postpartum care, which is critical to ensuring the mother’s health and well-being after childbirth.

The rising burden of non-communicable diseases (NCDs) such as obesity, diabetes, and hypertension is also contributing to the high maternal mortality rates in the U.S. Women with pre-existing NCDs are at a higher risk of developing complications during pregnancy and childbirth, which can lead to maternal death. In addition, pregnancy can exacerbate pre-existing NCDs, leading to maternal death.

What can be done to lower the number of maternal deaths?

In their most recent study (2017-2019), the CDC estimated that 84% of maternal deaths were determined to be preventable. A maternal death is considered preventable if there was at least some chance of the death being averted by one or more reasonable changes to patient, community, provider, facility, and/or systems factors.

The leading cause of maternal death—mental health conditions—is a condition ​​that is mostly preventable. Improving access to mental health care and increasing suicide prevention efforts could have a significant effect on reducing the numbers.

Similarly, providing better access to preventive care could help reduce the burden of non-communicable diseases such as obesity, diabetes, and hypertension that put women at a higher risk of developing complications during pregnancy and childbirth, which can lead to maternal death.

In general, lack of access to quality maternal healthcare services in rural areas and communities of color has contributed to the problem. This lack of access can lead to delays in seeking care or not receiving necessary care, which can increase the risk of maternal death. In addition, many women lack access to postpartum care, which is critical to ensuring the mother’s health and well-being after childbirth.

What can the Church do to help?

No matter their circumstances or conditions, every woman, baby, and family is valuable. Christians should show genuine care by supporting initiatives and policies ​​that help protect vulnerable mothers. 

When Christians show they care about women and are broken over the issues that arise when women don’t receive the care they need, the world sees a little more clearly that God cares for women. He cares for the broken. He cares for the hurting. As Christ’s ambassadors, God calls the Church to love women, babies, and families and to be conduits of life.

Pregnant women and their families, healthcare providers, hospitals and healthcare systems, and states and communities can all work together to reduce maternal mortality rates. And as churches invest themselves in their communities and pursue the well-being of their cities (Jer. 29:4-7), they are uniquely positioned to be a source of hope and light.

What is maternal mortality?
By / Aug 10

The United States is a technologically advanced country with trusted science and medicine. And many of us assume most individuals in this country have access to world-class medical care and that their health is always in good hands. Yet, according to the latest report from the Centers for Disease Control and Prevention (CDC), maternal mortality rates are on the rise in the United States. The World Health Organization (WHO) defines motherhood mortality as “the annual number of female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy.”

According to the most recent data from the CDC, in 2020, the maternal mortality rate in the United States—the number of maternal deaths per 100,000 live births—reached 23.8 compared with 20.1 in 2019. This rate indicates a total of 861 women who died of maternal causes in the United States in 2020 compared to 754 women in 2019, continuing an upward trend in maternal mortality rates in the U.S.

The data shows motherhood mortality rates rise significantly among women over the age of 40 and among non-Hispanic Black women. In 2020, the maternal mortality rate among non-Hispanic Blacks was 55.3 deaths per 100,000 live births, nearly three times the rate for non-Hispanic white women. This was a significant increase for non-Hispanic Black women from 2019 when the maternal mortality rate was 44.0. Among non-Hispanic white women, the rate only increased slightly from 2019 to 2020, rising from 17.9 to 19.1. Rates also increase with maternal age. Women over the age of 40 have the highest maternal mortality rate at 107.9—7.8 times higher than the rate for those under the age of 25.

Maternal mortality occurs as a result of complications during and following pregnancy and childbirth. According to WHO, some of these complications existed before and worsened during pregnancy. But most develop during a woman’s pregnancy and are preventable or treatable. Nearly 3 in 4 maternal deaths are caused by severe bleeding, infections, high blood pressure during pregnancy, complications from delivery, or unsafe abortion. These are all known complications with known solutions.

In a world marred by the consequences of sin, maternal deaths are not a new occurrence. There are women in the Bible who died of child birthing complications. Both Rachel (Gen. 35:16-20) and the wife of Phinehas (1 Sam. 4:19-20) died after prolonged and difficult labors. And despite our attempts to combat the consequences of sin with things like science and medicine, sin still affects our world today.

Protecting women’s lives

Today, healthcare providers have well-known solutions to prevent or manage maternal complications. WHO identifies two primary indicators for preventing maternal deaths: 1) Access to high-quality healthcare during pregnancy and childbirth as well as after childbirth; and 2) Access to contraceptives to prevent unplanned pregnancies (though Christians would not support the use of abortifacients or the morning after pill).

Sadly, there are still women in the United States who do not receive the care they need during or after their pregnancies. The five main factors that “prevent women from receiving or seeking care during pregnancy and childbirth” are:

  1. Poverty
  2. Distance to facilities
  3. Lack of information
  4. Inadequate and poor quality services
  5. Cultural beliefs and practices

WHO suggests that to “improve maternal health, barriers that limit access to quality maternal health services must be identified and addressed at both health systems and societal levels.”

The church’s response

So what should the church do? The church can start by genuinely caring. Christ-followers should care because all people have dignity and worth. No matter their circumstances or conditions, every woman, baby, and family is valuable. When Christians show they care about women and are broken over the issues that arise when women don’t receive the care they need, the world sees a little more clearly that God cares for women. He cares for the broken. He cares for the hurting. As Christ’s ambassadors, God calls the church to love women, babies, and families and to be conduits of life.

Pregnant women and their families, healthcare providers, hospitals and healthcare systems, and states and communities can work together to reduce maternal mortality rates. And as churches invest themselves in their communities and pursue the well-being of their cities (Jere. 29:4-7), they are uniquely positioned to be a source of hope and light.

At the state and community level, the CDC offers three specific steps toward reducing maternal deaths:

  1. Assess and coordinate delivery hospitals for risk-appropriate care
  2. Support review of the causes behind every maternal death
  3. Identify and address social factors influencing maternal health such as unstable housing, transportation access, food insecurity, substance use, violence, and racial and economic inequality

It may be easier for us to close our eyes and walk on the other side of the road (Luke 10:25-27), avoiding the hurt that could come from engaging with the rising issue of maternal mortality. But God calls the church to respond to suffering in the world around us. For example, in light of the recent Dobbs v. Jackson Women’s Health Organization Supreme Court decision, and the resulting restrictions on abortion, many pregnancy care centers across the nation are considering how they might meet the needs of the additional numbers of women and families who are walking through their doors for assistance. This has included adding more medical services, such as ultrasounds or STD-testing, which can be an important first step in prenatal care. 

God calls us to protect the physical lives of the vulnerable among us, seeking justice, loving mercy, and walking humbly with God (Micah 6:8) as we live out the call to love our neighbors as ourselves (Lev. 19:18). And he calls the church to be a light in this world, pushing back the darkness by physically caring for women while pointing them to the One who became vulnerable in order to make them whole (Matt.5:14-16).