WASHINGTON– The number of women who died from complications related to pregnancy and childbirth, known as maternal death, spiked during the pandemic, according to a report from the Government Accountability Office. It shows that COVID-19 was a contributing factor in one quarter of all maternal deaths in 2020 and 2021 combined.
The report also points out that racial and ethical disparities in the rate of maternal deaths worsened during the pandemic. Department of Health and Human Services officials said that the pandemic exacerbated the effects of social determinants of health on maternal health disparities. These social factors include access to care, transportation, technology, living environment, employment, etc.
This research sheds more light on the chronic maternal health crisis in the United States and how women of color suffer the most, particularly during the pandemic.
Black women experienced the worst maternal death rates during the pandemic, but as Maggie Clark, a senior state health policy analyst at Georgetown University, said, “no group is doing well here … all women had a really hard time.”
The maternal death rate for Black women was 44 per 100,000 live births in 2019, then increased to 68.9 in 2021. In contrast, White women had death rates of 17.9 in 2019, and 26.1 in 2021. The maternal death rate for Hispanic or Latina women in 2019 was 12.6, lower than White women. But it increased significantly during the pandemic to 27.5 in 2021 according to the report.
Both the virus and social factors played critical roles in the increase of maternal deaths. It was hard to compare which was worse, according to Carolyn Yocom, the director of the report.
In terms of social factors, especially racial disparities. Yocom said they affect maternal health in two aspects.
People subjected to racism face chronically increased stress. And pregnancy adds additional stress to their bodies. When the pandemic hit, women of color were disproportionately exposed to the virus. Public-facing jobs and limited living conditions made them less able to keep social distance. All resulted in a more dangerous situation for pregnant women of color.
Venicia Gray, the senior manager of maternal and infant health at the National Partnership for Women and Families, said the new data was “heartbreaking,” she was not surprised when she read the report. It just confirmed what her organization had known for a long time.
“Even before the pandemic, women of color were faced with multiple maternal health crises,” Gray said. “COVID-19 compounded those existing concerns.”
One week after the report came out, Rep. Lauren Underwood (IL) called on Congress to invest in key federal programs to improve maternal health outcomes.
“We need to make significant investments in maternal health and pass the Black Maternal Health Momnibus Act before the end of the year …. Every day that goes by without its passage is a disservice to millions of mothers and families,” Underwood said in her press release.
The Black Maternal Health Momnibus Act, introduced by several members of the Black Maternal Health Caucus in Congress, would expand Medicaid coverage, health insurance for low-income people. The current Medicaid coverage ends 60 days after delivery. Many experts recommended extending it to cover a full year after delivery.
“Some health conditions, such as hypertension, diabetes, injuries from childbirth and maternal depression, could be exacerbated several months after giving birth to babies,” said Maggie Clark. “Longer Medicaid coverage can create greater access to care for underserved pregnant women.”
Currently, states decide whether to extend Medicaid coverage. As of Nov. 10, 27 states have adopted the Medicaid postpartum coverage extensions, according to a Kaiser Family Foundation study.
From Clark’s perspective, extending Medicaid coverage is a positive step, but does not go far enough to address the crisis. “It has to be a holistic approach,” she said.
Experts say other important steps in remedying the racial disparity in maternal health include addressing systemic racism in the economy and health care system and improving access to paid family and medical leave.
Yocom stressed that the GAO would continue to work on reports about federal and state efforts to reduce the racial and ethical disparities in maternal health care.
“I don’t think we will make progress in reducing maternal health outcomes until we’re able to change this disparity,” she said.