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Last year, COVID-19 led to a dramatic increase in the number of women dying from complications of pregnancy or childbirth in the United States, according to a government report released Wednesday, a crisis that has left Black and Hispanic women disproportionately victimized.
The report lays out grim trends for pregnant women and their newborn babies across the country.
It found that pregnancy-related deaths have surged nearly 80 percent since 2018, with COVID-19 a factor in a quarter of the 1,178 deaths reported last year. The share of preterm and low birth weight babies also rose last year after remaining stable for years. More pregnant or postpartum women report depressive symptoms.
“Our country is already in the midst of a maternal mortality crisis,” said Karen Tabb Dina, a maternal health researcher at the University of Illinois at Urbana-Champaign. “It really shows that COVID-19 exacerbated the crisis to a rate that we as a nation cannot handle.”
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The nonpartisan U.S. Government Accountability Office, which authored the report, analyzed pregnancy-related deaths after Congress asked it to review maternal health outcomes in the 2020 Coronavirus Relief Act.
The maternal mortality rate in the U.S. is higher than in many other developed countries and had been rising in the years leading up to the pandemic, but COVID-19 has only made things worse for pregnant women.
Women who contract the virus during pregnancy face higher health risks. Staffing shortages and COVID-19 restrictions have created more barriers for expecting mothers to access in-person health care; the stress of the pandemic has exacerbated depression, a common illness during pregnancy.
Mental health issues could lead to an increase in pregnancy-related deaths, says Tabb Dina. Many women who experience depression and anxiety during or after pregnancy struggle to get the care they need.
“Mental health is the biggest pregnancy complication that we don’t understand,” she said.
Caroline Jocomb, director of the Government Accountability Office, noted that the deadliest period was between July and December last year, as the COVID-19 delta variant infected millions.
“It is clear from the data that the timing of the spread of the delta variant appears to correspond to a large increase in the number of deaths,” Yocom said.
Maternal mortality is especially pronounced among black women, who have long faced worse maternal outcomes than their peers.
Pregnancy-related deaths per 100,000 births rose from 44 in 2019 to 68.9 last year. The death rate for white women was 26.1 last year, up from 17.9 in 2019.
The death rate among Hispanics has been falling but has risen again during the pandemic, from 12.6 per 100,000 in 2019 to 27.5 last year.
Blacks and Hispanics also die at higher rates from COVID-19, in part because they have less access to health care and often work in essential jobs that expose them to the virus.
According to another GAO report, long before COVID-19 began to spread, the groundwork was laid for black, low-income and rural women to receive substandard pregnancy care — putting them at greater risk of pregnancy failure.
Hospitals have been cutting maternity services in rural areas, low-income communities and mostly black communities, the report said.
The review found that, as of 2018, more than half of rural counties had no hospitals providing pregnancy care.
“Reductions in hospital obstetric services in rural areas are associated with increases in out-of-hospital and preterm births, which may contribute to poor maternal and infant outcomes,” the report found.
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