During the last five years, a significant portion (almost a third) of mothers' deaths in the United States reported Wednesday when most new mothers thought it was clear over six weeks after birth.
Published in JAMA Network Open, the study was one of the first to track maternal health complications during pregnancy and the year after birth.
Pregnancy-related mortality rates in the US increased almost 28% between 2018 and 2022, researchers have fallen somewhat since 2021 at the height of the Covid-19 pandemic.
“Our research shows why we can't take our eyes off maternal health,” said Dr. Rose L. Morina, an associate professor of obstetrics and gynecology, gynecology and reproductive biology at Harvard Medical School and one of the study's authors.
Women “need access to high quality care from the moment of conception until one year after birth,” she added. The year after giving birth, the focus is on care, but “we're not there yet.”
The study was based on data from the Centers for Disease Control and Prevention's Reproductive Health Department that monitored maternal mortality and identified risks of late-born death.
The Trump administration closed the division last week amid a massive layoffs and agency restructuring. Departmental research aims to understand and narrow down those health gaps.
Cardiovascular disease was the leading cause of pregnancy-related deaths and was the leading cause of maternal deaths. Other main causes were cancer, psychological and behavioral disorders, and drug and alcohol-induced deaths. (Accidents, murders, and other specific deaths were not included in the analysis.)
The risks faced by women in the first year after birth were not well understood until recently. They are traditionally victimized at the last recommended test of a new mother six weeks after birth. This is a period when focusing mainly on the health of new babies.
The American College of Obstetrics and Gynecology recommends that all women see a doctor within the first three weeks of having a baby, with follow-up and ongoing care when necessary.
“If you have hypertension, see us three to five days after giving birth,” said Dr. Tamika Auguste, chairman of Women and Infant Services at Medstar Washington Hospital Center and author of the new guidelines.
“I haven't said, 'Let's wait six weeks,'” she added. “Everyone else wants to see it within two weeks, even if they don't have high blood pressure,” said Dr. Auguste. also, patients should be carefully screened for depression and mental health issues during that period.
With caution against maternal deaths, most states have urged Medicaid coverage to extend from 60 days after birth to a full year. Medicaid guarantees nearly half of pregnant women, but federal cuts could put coverage at risk, women's health advocates say.
The study also documented harsh racial, ethnic and regional disparities.
Native Americans and Alaska Native women died 3.8 times more than white women during pregnancy and the year after giving birth, while black women died 2.8 times more than white women. Hispanic and Asian women died at the lowest rate.
Additionally, mortality rates have more than tripled across states. Southeastern generally had a high pregnancy-related mortality rate: Alabama was at its highest, followed by Mississippi. The lowest prices across California across the nation were followed by Minnesota.
Pregnancy-related deaths were 44.1 deaths per 100,000 births in 2021, down from 25.3 deaths in 2018 to 32.6 deaths in 2022.
During this period, mother deaths also rose sharply in 2021, then calmed down somewhat in 2022.
Overall, a surge in deaths was observed in all age groups, but a disproportionate increase was seen among women aged 25-39. Cardiovascular disease played a leading role.
Pregnancy can affect the cardiovascular system and can exacerbate underlying conditions such as hypertension. At the same time, cardiovascular disease is more common in younger adults, Dr. Molina said.
“As a society, it seems we're getting sick sooner, so we're seeing this in that particular age group,” Dr. Molina said.
