While we might not always agree that statistics are reported correctly, especially since there is so much controversy over how covid deaths were reported between 2020-2022, we CAN depend on the total number of deaths that happened in a time period, regardless of what we attribute them to. In our full-spectrum doula training, we hope to teach a more analytical approach to understanding what's happening in maternal care. But it shouldn't take a doula training organization to start asking questions. We should all be asking questions about why the maternal health in the US is continuing to get worse and worse...
Whether or not you've attended one of our doula training workshops, I want to appeal to your critical thinking skills and show you some statistics that I find very interesting.
In 2021, the national maternal mortality rate was 32.9 deaths per 100,000 live births, the agency said, compared with a rate of 23.8 in 2020.
A 2024 study published in the American Journal of Obstetrics and Gynecology suggests there was a much lower national maternal mortality rate – 10.4 deaths per 100,000 live births — from 2018 to 2021.
For the sake of math... Let's look at the actual numbers, the actual mamas' lives lost:
2019: 754 maternal deaths
2020: 861 maternal deaths
2021: 1205 maternal deaths
2022: 817 maternal deaths
the number of deaths:
between 2019-2020: 107 MORE deaths
between 2020-2021: 344 MORE deaths
between 2021-2022: 388 LESS deaths
So if we look at the trends from pre-pandemic till what would be considered post-pandemic and since we can't see 2023's numbers yet, we need to just look at the trends for what we can find:
This means that when the numbers were increasing during the pandemic, they went up by 451 deaths BUT they have only come down by 388 deaths.
This means that even though the number appears to be decreasing, if we look since pre-pandemic, we have overall increased our number of maternal deaths by 63 families who lost their mamas. In our doula certification training workshops, we always talk about risk vs benefit and we highlight that one of the worst risks of giving birth in the US is simply being black. This is why we train our doulas how to recognize and navigate racial disparities as they happen, in the hopes of saving even one family from losing their precious maternal figure.
Here is a visual way to look at the numbers:
So, while the black maternal mortality rate stayed high with an increase, the Native American population saw a HUGE increase and is otherwise underreported.
Mamas who were younger barely saw much of an increase in death rate during the pandemic. Whereas "older" mothers saw a clearly substantial increase!
If we put those 2 graphs together, we see a severe increase in deaths for black and brown mothers who were older. Specifically of Indigenous and African descent.
We also clearly see that the Black mothers continue to have the worst outcomes among all people groups, as statistically recorded.
The thing that isn't clicking for me is that the spike in maternal mortality during and after the pandemic time period, does not follow the same trend at covid deaths - even though it's very often attributed to that. The covid deaths were calming down by March of 2022 and almost back to baseline by April 2022, but we still have significantly poor outcomes for maternal health until January of 2023.
So what I'm deducing from these stats is this...
The maternal mortality rate was not directly correlative to cases of covid infection.
The difference in the death rates between covid related general population and the maternal mortality rate is that the "spikes" are occurring at different time periods. The maternal mortality rate is showing up as LATER, AFTER the worst spikes in covid deaths are already beginning to resolve and they stay high months after the general population has already gone down to nearly "normal".
Why?
Could it be care protocols?
Could it be the increase in inductions and cesareans?
These are questions I want answers to, because we at MaternityWise exist to improve outcomes and these outcomes have a cause - and it's not clear what that cause is, even though I have some pretty strong opinions on what I think it could be.
We will continue to follow the facts and rely on statistics as they are reported. Please share your thoughts in the comments.
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