USA — A recent study published in the Journal of American Medical Association (JAMA) reveals a disturbing trend in maternal mortality rates in the United States.

The research indicates that the number of women who died within a year after pregnancy more than doubled between 1999 and 2019, with the highest number of deaths occurring among Black women.

The study estimated 1,210 maternal deaths in 2019 compared to 505 in 1999, highlighting a significant rise in mortality rates over time.

The research also highlights the disproportionate impact on specific racial and ethnic groups. American Indian and Alaska Native women experienced the greatest increases in maternal mortality over the study period.

The number of deaths per 100,000 live births rose across all groups, with the highest increase observed among American Indians and Alaska Natives, followed by Blacks.

The estimates indicate a rise in deaths from 12.7 to 32.2 per 100,000 live births overall, with even higher rates among specific ethnic populations.

For instance, the study reported a rise of 14.0 to 49.2 among American Indians and Alaska Natives, 26.7 to 55.4 among Blacks, 9.6 to 20.9 among Asians, Native Hawaiians, and Other Pacific Islanders, 9.6 to 19.1 among Hispanics, and 9.4 to 26.3 among whites.

Unlike previous studies that focused on national trends, this study examined the data state-by-state. The findings revealed dramatic jumps in maternal mortality rates when comparing the first and second decades of the study.

State-by-state analysis

Notably, the study identified the five states with the largest increases in maternal mortality between those periods, shedding light on the disparities across different regions of the country.

The highest increases in maternal mortality rates were observed among American Indian and Alaska Native mothers in Florida, Illinois, Kansas, Rhode Island, and Wisconsin.

White mothers in Georgia, Indiana, Louisiana, Missouri, and Tennessee also experienced significant spikes.

Hispanic mothers in Georgia, Illinois, Indiana, Minnesota, and Tennessee, as well as Black mothers in Arkansas, Georgia, Louisiana, New Jersey, and Texas, were also disproportionately affected.

Furthermore, Asian and Pacific Islander mothers in Georgia, Illinois, Kansas, Michigan, and Missouri experienced alarming increases in maternal mortality rates.

The study’s findings also emphasize the stark reality of maternal mortality in the United States compared to other wealthy nations.

The country has the highest rate of maternal mortality, defined as a death during pregnancy or up to a year afterward.

The COVID-19 pandemic has likely exacerbated the existing demographic and geographic trends, emphasizing the need for further research in this area.

While preliminary data suggests a decline in maternal mortality rates in 2022 compared to the previous year, it remains a critical issue that requires attention and action.

Various factors contribute to maternal mortality, including excessive bleeding, infection, heart disease, suicide, and drug overdose.

Geographically, Southern states exhibited high maternal mortality rates across all racial and ethnic groups, particularly among Black individuals.

On the other hand, Midwest and Great Plains states had the highest rates for American Indian and Alaskan Native women.

One notable discovery from the study is the higher maternal mortality rates among Black women in some Northeast states, challenging the notion that the South consistently has the worst rates.

Disparities in maternal mortality rates persist across populations, even in states commonly regarded as having better outcomes for maternal health, such as California and Massachusetts.

The study further reveals the most common causes of death within one year after pregnancy, including mental health conditions, excessive bleeding, cardiac and coronary conditions, infections, blood clots, and pregnancy-related high blood pressure.

These findings align with data from the U.S. Centers for Disease Control and Prevention.

“It’s a call to action to all of us to understand the root causes — to understand that some of it is about healthcare and access to health care, but a lot of it is about structural racism and the policies and procedures and things that we have in place that may keep people from being healthy,” said Dr. Allison Bryant, one of the study’s authors and a senior medical director for health equity at Mass General Brigham.

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