The latest figures on maternal mortality in the United States are a good news, bad news story.
The good news: The numbers are way down since jumping significantly during the pandemic.
The bad news: The chance of new mothers dying during pregnancy, during childbirth or in the weeks after remain much higher in the U.S. than in any developed nation in the world.
There’s no secret as to what happened in 2021, when the rate jumped to 33 maternal deaths for every 100,000 live births — a more than 30% increase from the year before. COVID-19 is what happened.
As the virus spread in this country, it significantly increased the odds of a bad outcome for pregnant women. A big reason for that was the biological effect of the virus itself, which is particularly hard on individuals whose health is already compromised. A secondary impact, though, was COVID’s impact on health-care delivery. With doctors and nurses strung out in dealing with the virus, and with providers naturally reluctant to have much face-to-face contact with patients, pregnant women, particularly those from low-income backgrounds, got less medical attention.
Although the final numbers for 2022 are still to be determined, the preliminary indication is that the worst is over. The maternal death rate should be back close to where it was before the pandemic.
That’s a victory, but it’s only a partial one, as the pre-pandemic rate in the U.S. was nothing to be proud of. Other developed nations have rates that are one-third to one-eighth the size of ours.
What’s the difference? Obviously, health care is more equitably distributed in other parts of the developed world. In this nation, if you are poor, the care you receive may be less than the norm. That may be because the pregnant mother doesn’t seek care early enough, or doesn’t follow the advice the provider gives. But it’s also suspected that the poor, whose pregnancy is covered by Medicaid, don’t get the same attention and quality of care from their doctor as those who are on private insurance.
That’s a particularly poignant issue in Mississippi, where more than 60% of pregnant women are covered by Medicaid. It’s probably no coincidence that Mississippi also has one of the highest maternal mortality rates in the nation.
The state’s recent decision to extend Medicaid’s postpartum coverage for new mothers to 12 months is supposed to help reduce that. It should to some degree but probably not as much as proponents have suggested. That’s because most of the bad outcomes are occurring either during the pregnancy or shortly after giving birth — even before the extended care kicks in.
Not just Mississippi but the whole nation needs to be focused on addressing this problem. There’s no acceptable reason for pregnancy and childbirth to be so much more dangerous in this country than in those nations to which we usually compare ourselves.
