Serious disparities persist in maternal death rates in the U.S.

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U.S. maternal death rates have largely returned to pre-pandemic levels, but serious disparities persist. A recent study finds that the rate of maternal deaths in the United States disproportionately impacts Black women. Read the full article.

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Welcome to Health Lab, your destination for news and stories about the future of healthcare.

Today: New research shows that maternal deaths rose during the COVID-19 pandemic, and they remain elevated for Black women. The recent study finds that U.S. maternal death rates have largely returned to pre-pandemic levels, but disparities persist, particularly in later postpartum deaths.

During the COVID-19 pandemic, maternal deaths in the United States increased sharply, and a new study finds that the greatest impact was seen among Black women.

And while maternal death rates have since returned to pre-pandemic levels for most groups of birthing parents, they remain significantly higher for Black mothers, according to the Michigan Medicine research in Obstetrics & Gynecology.

The study’s senior author, Lindsay Admon, M.D., M.Sc., an Associate Professor of Obstetrics and Gynecology at the University of Michigan Medical School and an obstetrician-gynecologist at U-M Health says, “We saw a dramatic increase in maternal deaths during the COVID-19 pandemic, but the recovery has not been equal across all groups.” She goes on, “We need to better understand what’s driving these differences so we can develop solutions that reduce maternal deaths and improve outcomes for everyone."

The U.S. has long had the highest maternal mortality rate among peer nations, and the COVID-19 pandemic made the crisis worse.

For more context, maternal deaths, which are defined as deaths occurring during pregnancy or within 42 days after, rose more than 60% during the COVID-19 pandemic, this was a sharp increase from pre-pandemic levels of about 20 deaths per 100,000 live births in 2019 to 33 deaths per 100,000 live births in 2021.

From 2018 to 2024, the U.S. reported a total of 8,298 maternal deaths. Most of the increase in maternal deaths during the pandemic was linked to COVID-19–associated deaths, with early pregnancy deaths rising by 7.5 per 100,000 live births and later maternal deaths by 3.7 per 100,000.

However by 2023–2024, early maternal deaths had returned to pre-pandemic levels, but later postpartum deaths remained elevated. 

Recovery varied across groups, with the largest increases in maternal deaths occurring among non-Hispanic Black and American Indian or Alaska Native mothers, and older birthing people ages 40–49.

Both early and late maternal death rates remained notably higher for non-Hispanic Black mothers.

Dr. Admon says, “Our findings show that COVID-19–related deaths drove much of the increase during the pandemic. They also highlight persistent racial disparities in maternal deaths. While progress has been made, more work is needed, especially to reduce later maternal deaths and improve outcomes for Black mothers.”

The study highlights the need to evaluate policies that may influence maternal health, Dr. Admon says, including pandemic-era measures such as extended Medicaid coverage under federal relief programs.

“There is an urgent need to understand how both pandemic and post-pandemic policies have affected maternal health,” Admon says. "This work can help guide public health and policy efforts to reduce maternal deaths and improve health equity for mothers, children and families.”

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