Maternal Death Rates are dropping. Here’s why doctors aren’t satisfied.

A recent federal analysis found that after peaking in 2021, maternal death rates decreased in 2022.

TFD – Discover the positive trend in maternal death rates in 2022 while acknowledging persisting challenges and disparities in maternal healthcare.

After a concerning 2021 rise, the number of pregnant women dying is now back to pre-pandemic levels, according to a recent study from the Centers for Disease Control and Prevention.

2022 saw a decrease in the number of American women dying during pregnancy or shortly after giving birth to 817 from 1,205 the year before.

We were really still in the pandemic and dealing with disruptions of care, the fear of coming into the healthcare space, and the inability to access care during that time,” OB-GYN Dr. Veronica Gillispie-Bell of Ochsner Medical Center in Kenner, Louisiana, said of the sharp increase in 2021. The CDC’s National Center for Health Statistics released the updated study on Thursday; she was not engaged in it.

“It appears to be reverting to its pre-pandemic state,” stated Donna Hoyert, the lead author of the study and a health scientist at NCHS. The same appears to be true for preliminary 2023 data, she said.

All age categories and races showed declines, but Black women continue to be disproportionately impacted. In 2022, there were 49.5 maternal deaths for per 100,000 live births. It was 69.9 deaths per 100,000 in 2021.

“We still have a long way to go to create really meaningful prevention interventions and strategies to decrease mortality,” said Dr. Warner Huh, an OB-GYN and head of obstetrics and gynecology at the University of Alabama at Birmingham, “particularly among Black women and women of color.” Huh was not involved with the NCHS report.

Maternal mortality data from NCHS death certificates have long been subject to scrutiny for their accuracy. The research team discovered over ten years ago that several deaths involving expectant mothers were not being recorded due to an issue in medical coding.

In an attempt to address the problem, the NCHS suggested in 2003 that states include a uniform checkbox on the certificates to indicate if the death involved a pregnant or recently pregnant woman. Not until 2017 did every state implement the reform.

A study published last month suggested the checkbox rule grossly overestimated rates of maternal mortality because it wasn’t nuanced enough to determine whether the cause of death was truly related to pregnancy.

Gillispie-Bell, also the medical director of the Louisiana Perinatal Quality Collaborative at the state’s department of health, said she disagreed with those findings because they did not account for mental health conditions.

Additionally, the most common cause of death during or shortly after pregnancy, as reported by the CDC, is associated with mental health issues, such as drug and alcohol use disorders.

According to Hoyert, her team is still working to improve the data’s quality.

“If we didn’t use the checkbox, we would be right back where we were in the past, when we were getting roundly criticized for missing a substantial percent of maternal deaths,” she said.

While it appears that the numbers are “trending in the right direction,” Huh said, “they’re still too high.”

Gillispie-Bell stated, “No mother should enter into a pregnancy believing she will not survive the birth of her child.” “As long as mothers are dying, we still have work to do.”