Pregnancy-related deaths are dropping. Here’s why doctors aren’t satisfied.


The number of women dying while pregnant is returning to pre-pandemic levels following a worrisome 2021 spike, a new report from the Centers for Disease Control and Prevention shows.

In 2022, 817 U.S. women died either while pregnant or soon after giving birth, down from 1,205 the previous year.

“If you look at 2021, we had such a sharp increase as we were really still in the pandemic and still dealing with disruptions of care, the fear of coming into the healthcare space and the inability to access care during that time,” said Dr. Veronica Gillispie-Bell, an OB-GYN at Ochsner Medical Center in Kenner, Louisiana. She was not involved in the new report, which was published Thursday by the CDC’s National Center for Health Statistics.

The maternal mortality rate in 2022 was 22.3 deaths per 100,000 live births, compared with 32.9 per 100,000 in 2021, according to the new report.

“It’s looking like it’s returning to a pre-pandemic level,” said Donna Hoyert, the report’s author and an NCHS health scientist. The same appears to be true for preliminary 2023 data, she said.

Decreases were noted across all age groups and races, though Black women continue to be disproportionately affected. Their maternal mortality rate was 49.5 deaths per 100,000 live births in 2022. In 2021, it was 69.9 deaths per 100,000.

“We still have a long way to go to create really meaningful prevention interventions and strategies to decrease mortality,” said Dr. Warner Huh, an OB-GYN and head of obstetrics and gynecology at the University of Alabama at Birmingham, “particularly among Black women and women of color.” Huh was not involved with the NCHS report.

The accuracy of NCHS’s maternal mortality data, which comes from death certificates, has long been scrutinized. More than a decade ago, the research group noted that many deaths among pregnant women were not being counted because of a problem with medical coding.

In 2003, the NCHS tried to correct the issue by recommending that states add a standardized checkbox to the certificates to make it clear whether the death occurred in a pregnant or recently pregnant woman. It wasn’t until 2017 that all states made the change.

A study published last month suggested the checkbox rule grossly overestimated rates of maternal mortality because it wasn’t nuanced enough to determine whether the cause of death was truly related to pregnancy.

Gillispie-Bell, also the medical director of the Louisiana Perinatal Quality Collaborative at the state’s department of health, said she disagreed with those findings because they did not account for mental health conditions.

And according to CDC data, the most common cause of death during or just after pregnancy is related to mental health conditions, which include drug and alcohol use disorder.

Hoyert said her group continues to refine the quality of the data.

“If we didn’t use the checkbox, we would be right back where we were in the past, when we were getting roundly criticized for missing a substantial percent of maternal deaths,” she said.

While it appears that the numbers are “trending in the right direction,” Huh said, “they’re still too high.”

“No mother should come into pregnancy with a fear that she is going to die delivering her baby,” Gillispie-Bell said. “As long as mothers are dying, we still have work to do.”


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