A recent report from the U.S. government has highlighted a troubling trend: an increase in maternal mortality rates from 2018 to 2022. The report unequivocally labels this issue as “an urgent public health priority.” This alarming finding comes at a time when federal health agencies responsible for addressing these deaths face significant job and funding cuts, raising concerns about the future of maternal health initiatives.
In the past week, a substantial portion of the department dedicated to monitoring and improving maternal and child health at the Centers for Disease Control and Prevention (CDC) was placed on leave. Additionally, several researchers focused on maternal mortality have experienced funding rescissions, further complicating efforts to tackle this pressing issue. Rose Molina, an OB-GYN at Harvard Medical School and a co-author of the study, expressed concern: “It’s a hard time for this to come out. We cannot take our eyes off of maternal health right now, and if anything, we need to not just maintain focus, but actually increase investment in maternal health.”
The newly published paper, appearing in JAMA Network Open, builds on previous research by analyzing maternal deaths up to a year postpartum. This expanded scope revealed that leading causes of late maternal deaths include cardiovascular disease, cancer, and mental disorders. By utilizing data from a CDC database distinct from the heavily affected Pregnancy Risk Assessment Monitoring System, the study found that maternal mortality increased from 25.3 deaths per 100,000 live births in 2018 to 32.6 per 100,000 in 2022, marking a significant age-adjusted increase of approximately 27%.
Marie Thoma, a reproductive and perinatal epidemiologist at the University of Maryland, noted that the findings align with prior research on maternal mortality trends during the COVID-19 pandemic. However, this study provides vital insights into state-level mortality rates and underscores the persistent inequities faced by racial and ethnic groups. Alarmingly, American Indian and Alaska Native women experience maternal mortality rates 3.8 times higher than those of white women, while Black women face rates that are 2.8 times higher.
Despite these challenges, there are glimmers of hope. Thoma points to California as a model for success, as the state boasts the lowest rate of maternal mortality in the nation. The authors of the study noted that if the nationwide rates of maternal mortality were brought down to California’s level, it could have saved an astounding 2,679 pregnancy-related deaths. “There was a lot of momentum,” Thoma remarked, referencing a Biden administration blueprint aimed at improving maternal health. Yet, she acknowledged the current climate of uncertainty surrounding these efforts.
Kisha Davis, a board member at the American Academy of Family Physicians and chief health officer for Montgomery County, Maryland, has observed progress in addressing racial disparities in local hospitals. She shared positive data reflecting successful interventions, including training clinicians on implicit racial bias and equipping non-OB-GYN physicians to better support mothers. However, the recent cuts to programs aimed at mitigating these disparities have raised concerns, as highlighted by Marian Jarlenski, a health policy professor at the University of Pittsburgh.
Jarlenski pointed out that while some initiatives initiated during the Trump administration continue to operate, the National Institutes of Health (NIH) has recently cut funding for several maternal health research centers. “This study shows why this is not a political issue,” she asserted, emphasizing the importance of collaboration across sectors to effectively reduce maternal mortality rates. The challenges ahead are significant, but the call for renewed focus and investment in maternal health remains critical.
