April 11-17 is Black Maternal Health Week-- a time to shine the spotlight on maternal and child health inequities impacting Black women and people. If you read health news regularly, you might have seen an alarming statistic in the headlines: maternal deaths increased in the U.S. in 2021. While these deaths are thankfully rare in Dane County, every parent that dies during pregnancy, birth, or postpartum is a tragedy. Even more alarming, deaths are even higher for Black women and people-- an inequity driven by our systems and environment. We pay attention to national trends so that we can take action to better support parents and families.
A maternal death is when a person dies during pregnancy or up to 42 days after the end of pregnancy, from a health problem related to the pregnancy.People may die from infections, blood loss, high blood pressure, heart conditions, and many other causes. It’s also important to know that for every one maternal death, around 70 people almost die during pregnancy or birth.

Maternal deaths increased by 40% from 2020 to 2021 in the United States.

According to a recent report from the CDC, 1,205 people died of maternal causes in the United States in 2021. That’s compared to 861 people who died in 2020 and 754 people in 2019. This has happened as birth rates have trended downward since the mid-2010s.

Image showing maternal deaths increasing by 14% from 2019-2020 and 40% from 2020-2021
Source: Centers for Disease Control and Prevention (CDC)

Black women are over twice as likely as white women to die within 6 weeks of giving birth.

The reason why this inequity exists is complex and woven into our systems and environment. Multiple factors likely contribute to this inequity, including structural racism, implicit bias, underlying chronic conditions (which are also influenced by structural racism), and unequal care from health systems.
image showing maternal deaths among white women being 27 deaths per 100k births, Hispanic women as 28 deaths per 100k births, and Black women as 70 deaths per 100k births.
Source: Centers for Disease Control and Prevention (CDC)

We don’t know all of the reasons why deaths are increasing. But the COVID pandemic has offered some clues.

In addition to maternal deaths, pregnancy-related deaths (deaths within one year after birth related to pregnancy) also increased in 2021. Pregnancy-related deaths increased consistently along with rising rates of COVID-19–associated deaths among women of reproductive age. While this is only a correlation, it makes sense that both COVID infection and the reduced amount of health care capacity could have contributed to pregnancy-related deaths. We will likely learn more as researchers continue to study this.

How does this affect Dane County?

Thankfully, maternal deaths are not common enough for Dane County to experience them very often. But we are working to change the systems surrounding pregnancy and infant health so that we can support the health and wellbeing of all families.

FIMR: We coordinate a Fetal and Infant Mortality Review (FIMR) process to improve our understanding of the conditions that contribute to stillbirth and infant death. We work collaboratively with experts in fetal and infant health to address the systems that contribute to infant mortality.

Perinatal nurse programs: We offer free home visiting programs for pregnant people living in Dane County. Nurse Family Partnership and Perinatal Care Coordination provide pregnant people with the support and information to have a healthy pregnancy and a healthy baby.

Nurse Navigator program: Soon we will be launching our new Nurse Navigator program to help people in Dane County get the help, support, and resources they need regarding reproductive health, pregnancy support, and all-options counseling, including helping to navigate abortion access.

Dane County Health Council: We are a partner in the DCHC and collaborate with health systems and community organizations to reduce Black infant deaths, including investing in doulas and improving referrals between systems.

2022 abortion restrictions have the potential to further impact maternal mortality.

States with more abortion restrictions have higher rates of maternal mortality, and many states became much more restrictive after the U.S. Supreme Court struck down Roe v. Wade in 2022. Pregnant people in states with abortion bans, such as Wisconsin now does, have more limited access to health insurance, worse health outcomes, and lower access to maternity care providers. 

We can do better.

The United States has a maternal mortality rate that is much higher than other high-income countries. We don’t have to accept our current state as inevitable. We could prioritize preventing maternal deaths as a country through funding, policies, and support for families. Until then, we’re doing what we can at a local level to support pregnant people and families. You can find out more about our work on our website. Learn more about Black Maternal Health Week from the Black Mamas Matter Alliance.

This content is free for use with credit to the City of Madison - Public Health Madison & Dane County and a link back to the original post.