Amount women in the United States die during pregnancy or shortly after childbirth spiked during the first year of the coronavirus pandemic, according to a new study, an increase that health officials attribute in part to Covid and pandemic-related disruptions.
A new report from the National Center for Health Statistics shows that the number of maternal deaths has increased by 14%, from 754 in 2019 to 861 in 2020.
The United States has many higher maternal mortality rate compared with other developed countries and rising mortality rates push the country’s maternal mortality rate to 23.8 deaths per 100,000 live births in 2020 from 20.1 deaths in 2019. Maternal mortality rates in developed countries in recent years have ranged from less than two deaths per 100,000 live births in Norway and New Zealand to less than nine deaths per 100,000 live births. live in France and Canada.
Black women in America experience the most deaths: One-third of pregnant women and new mothers who die in 2020 are Black, even though Black Americans make up just over 13% of the population. Their mortality rate is nearly three times that of white women.
Mortality rates among Hispanic women, previously lower than white women, also increased significantly in 2020 and are now almost equal to rates among white women. Mortality rates increase in all pregnant women over the age of 24, but especially in those aged 40 and older, there is a mortality rate nearly eight times that of women under 25.
Kara Zivin, professor of psychiatry and obstetrics and gynecology, said: “Our maternal morbidity and mortality rates are among the highest in the developed world and this trend continues despite our perception of it. , despite our maternal mortality review committees, despite the press attention. and gynecology at the University of Michigan, who researches access to care during and after pregnancy. “Whatever we’re doing is clearly not enough to address overall rates or disparities.”
Although the new report contains few details – no maternal mortality figures were provided for American Indian/Alaska Native women, who had higher rates of pregnancy-related mortality than women. Caucasian, Hispanic and Asian/Pacific Islander women – experts say some of the deaths are most likely linked to the coronavirus pandemic. Pregnancy puts women at greater risk for severe illness if they become infected with the SARS-CoV-2 virus, which causes Covid, and a vaccine is not available to them in 2020.
Denise Jamieson, an obstetrician at Emory University in Atlanta and a member of the Covid expert team at the American College of Obstetricians and Gynecologists, added that she was not surprised by the increase.
Beyond the larger risks that pregnant women with Covid face, she said, “we haven’t figured out how to safely provide obstetric care in 2020.”
“Our health system is not yet set up to manage health remotely,” she said, “and there are other barriers: Children come home from school and parents cannot go to the doctor.”
Many doctors are no longer seeing patients in person, hospitals are often crowded, and patients avoid emergency rooms filled with Covid patients.
Pregnant women develop Covid face higher risks require intensive care or mechanical ventilation. And although pregnant women are relatively young, they face a higher risk of death, studies show. Health professionals have encouraged them to get vaccinated, but their vaccination rates remain low.
Black Americans overall have suffered disproportionately from the pandemic, with higher rates of hospitalization and death than whites, but racial disparities in maternal mortality rates precede and beyond Covid, and stemming from structural health inequalities that have complex root causes.
Dr Mary D’Alton, chair of the department of obstetrics and gynecology at Columbia University Irving Medical Center, said stress, mental health problems and substance abuse increased during the pandemic and also may contribute to worse outcomes.
New programs that provide enhanced services to patients, such as doulas, who can support and advocate for patients, are positive advances, she said.
“We also have to educate our providers on how to listen to patients,” says Dr. D’Alton. “My dad was a primary care doctor and he used to say, ‘Mary, if you want to know what’s wrong with a patient, ask them and they’ll tell you. But first, you have to listen to them. ‘”
She added: “Complaints of pregnant women are often dismissed, and that probably makes a lot more sense for Black and brown women.
In general, the leading causes of pregnancy-related deaths are cardiovascular conditions, other medical conditions, and infections. Research has found that cardiomyopathy, a disease of the heart muscle; blood clots to the lungs; and hypertensive disorders of pregnancy contribute to pregnancy-related mortality in Black women compared with white women.
One of the new mothers who died in 2020, whose story has been widely reported, was Dr. Chaniece Wallace, a black physician who was chief physician of pediatrics at Indiana University School of Medicine in Indianapolis.
Dr. Wallace developed a pregnancy complication called preeclampsia and her baby girl was delivered prematurely by cesarean section in October 2020. But Dr. Wallace continued to develop further complications and The little girl died just a few days after giving birth.
https://www.nytimes.com/2022/02/23/health/maternal-deaths-pandemic.html Maternal deaths increase in first year of pandemic