Last week, the Centers for Disease Control and Prevention (CDC) released the United States’ maternal mortality statistics for 2020, and the results illustrate the continuation of a disturbing trend. Alarmingly, the overall maternal mortality rate—defined by the CDC and World Health Organization as “the number of deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 421 days of termination of pregnancy”—increased from 2019 to 2020.

This increase is driven by worsening maternal health outcomes, which have only become more disparate: Black women2 are three times as likely to die from pregnancy-related causes as white women. The Century Foundation’s Dr. Jamila Taylor, a national leader in maternal health policy, released a statement on what these data mean for Black women and birthing people. Here, the TCF health care team dives deeper into these statistics and the action necessary to reverse this trend.

Maternal Mortality in the U.S. Far Outstrips That of Other Industrialized Nations

In 2020, the U.S. maternal mortality rate was 23.8 deaths per 100,000 live births, with 861 known deaths due to maternal causes. It is crucial to note that this is not the case in similar countries, and is far from an inevitability. The United States continues to be an outlier among industrialized nations, with a maternal mortality rate several times higher than other high-income countries. The maternal mortality rate in the United States is nearly three times higher than that of France, the country with the next highest rate.

Figure 1

Black Women Face Three Times the Maternal Mortality Risk as White Women

Even more concerning, however, is that the overall maternal mortality rate masks stark disparities by race and ethnicity. As illustrated by the below chart, Black women bear the brunt of this horrific burden. Due to systemic racism and discrimination at the individual level, Black women and birthing people face unnacceptable (and mostly preventable) risk during childbirth and throughout and after pregnancy. It must also be noted that Hispanic women saw the largest maternal mortality increase of any racial or ethnic demographic group in the study, rising by a staggering 44 percent in just one year.

Figure 2

The U.S. Maternal Mortality Rate Continues to Increase Substantially

Unfortunately, this is not the first year that the U.S. maternal mortality rate has increased: in fact, it has done so consistently since reporting changes to reporting requirements improved identification of maternal deaths in 2018. And before 2018, the United States had not officially reported a maternal mortality rate since 2007. The 2020 numbers—from the first year of the COVID-19 pandemic, a virus which places pregnant people at disproportionate risk—highlight the urgency of this moment. We must act now to reverse this trend and save the lives of pregnant and birthing people.

Figure 3

A Call to Action

These statistics paint a grim picture of the risk faced by Black women and birthing people. Although these graphs can provide insight into the scope of this crisis, they cannot capture the true scale of this tragedy: each person represented in the CDC’s statistics is a life lost too soon, leaving loved ones to grieve at a time when they should be celebrating new life. Now more than ever, we must act to end the maternal health crisis in America—a country that spends more per capita than any other country on health care—and create a reality where no person fears for their life during their pregnancy.

Fortunately, we already have many of the policy tools necessary to tackle this emergency: all that remains is to pass them into law. The stalled version of the Build Back Better Act includes crucial maternal health investments: Congress must pass these investments immediately so that resources can become available to address the Black Maternal Health crisis once and for all. As TCF analyses demonstrated, these funding provisions will have substantial impacts on postpartum health coverage and the creation of a more robust and diverse perinatal workforce, among other advancements. Furthermore, all twelve pieces of legislation included in the Black Maternal Health Momnibus were developed as a comprehensive response to this crisis, including addressing the social determinants of health, supporting access to maternal mental health services, improving data collection, and so much more. It is time to implement these solutions: Black mothers and birthing people cannot wait any longer.

Notes

  1. Pregnancy-related deaths can occur up to a year after giving birth. Although reliable, the CDC’s estimates of maternal mortality are likely an undercount of the true magnitude of pregnancy-related deaths across the United States.
  2. Note that throughout this commentary we often refer to women, rather than the more inclusive categorization of women and birthing people, in order to reflect language used by the CDC.