A recent study reveals a concerning surge in maternal deaths across the United States over two decades, highlighting stark racial and geographic disparities. Published in the Journal of the American Medical Association, the research examined maternal mortality rates between 1999 and 2019, excluding the pandemic period, providing a state-by-state analysis for five racial and ethnic groups.

The study's findings paint a disturbing picture of unequal maternal health outcomes. Black mothers faced the highest mortality rates nationwide, while American Indian and Native Alaskan mothers experienced the most significant increases in deaths. Certain states, and specific racial or ethnic groups within those states, fared considerably worse than others.

Dr. Allison Bryant, a study author and senior medical director for health equity at Mass General Brigham, emphasized the need for a comprehensive understanding of the root causes. She stressed that while access to healthcare plays a role, structural racism and existing policies and procedures significantly contribute to these disparities.

The U.S. holds the grim distinction of having the highest maternal mortality rate among developed nations, defined as death during pregnancy or up to a year postpartum. Leading causes include excessive bleeding, infection, heart disease, suicide, and drug overdose.

Utilizing national vital statistics data on deaths and live births, researchers employed a modeling process to estimate maternal mortality per 100,000 live births. Their analysis revealed widespread and growing disparities, demonstrating that high maternal mortality rates extend beyond the South to regions like the Midwest and states such as Wyoming and Montana.

Comparing the first and second decades of the study, researchers found alarming increases in maternal mortality. For instance, increases surpassed 162% for American Indian and Alaska Native mothers in several states, including Florida, Illinois, Kansas, Rhode Island, and Wisconsin. Similar substantial increases were observed for white, Hispanic, Black, and Asian and Pacific Islander mothers across various states.

Dr. Karen Joynt Maddox, a health services and policy researcher, expressed concern over the findings, emphasizing the urgent need to address the underlying causes. She highlighted the U.S.'s underinvestment in social services, primary care, and mental health compared to other developed nations, citing Missouri's inadequate public health funding and delayed Medicaid expansion as examples.

The study's authors acknowledge that the pandemic likely worsened these trends, calling for further investigation into its impact. Preliminary federal data suggests a decrease in maternal mortality in 2022 after a sharp rise in 2021 attributed to COVID-19. However, the 2022 rate remains alarmingly high.

Experts underscore the critical importance of understanding these disparities to develop targeted community-based solutions. Efforts such as utilizing telemedicine, implementing perinatal quality collaboratives to disseminate best practices, and increasing access to care are crucial steps toward addressing this pressing public health crisis.