Pregnancy Deaths In U.S. Too High, Particularly Among Minority Women, CDC Reports

A surprisingly large number of women in the U.S. die as a result of pregnancy complications, especially women of color, according to the findings of a new study that suggests the majority of these pregnancy deaths are preventable.

The U.S. Centers for Disease Control and Prevention (CDC) analyzed national data for more than 3,000 pregnancy related deaths from 2011-2015, as well as deaths from 13 state maternal mortality review committees from 2013-2017. The findings were published this week in the agency’s Vital Signs Report.

CDC researchers found that 700 pregnancy deaths occur every year, and women may die up to one year after delivery as a result of complications. According to their findings, about 60% of those deaths are preventable.

The findings indicate almost one-third of those deaths happen during pregnancy, about one-third occurred during delivery or in the week directly following delivery, and another third occur one week to one year after delivery.

One-third of pregnancy-related deaths were caused by heart disease and stroke. However, other main causes include infections and severe bleeding.

Most deaths that occurred at delivery were caused by severe bleeding and amniotic fluid embolism, when amniotic fluid enters a mother’s bloodstream. For deaths occurring one week after delivery primary causes of death included severe bleeding, high blood pressure, and infection.

In comparison, cardiomyopathy, or heart disease, was the primary cause of death for those occurring one week to one year after delivery.

Researchers also noted there were persistent racial disparities among women who suffered pregnancy-related deaths. Black and American Indian/Alaska Native women were three times as likely to die from pregnancy related causes as white women.

Racial bias plays a role in part, preventing women of color from getting necessary care. Other factors include doctors failing to recognize risk factors that are especially prevalent in minority communities.

Nearly 60% of deaths, including those among Black and Native American women, could have been prevented by addressing these conditions, according to the findings.

“Ensuring quality care for mothers throughout their pregnancies and postpartum should be among our Nation’s highest priorities,” CDC Director Robert R. Redfield, said in a press release. “Though most pregnancies progress safely, I urge the public health community to increase awareness with all expectant and new mothers about the signs of serious pregnancy complications and the need for preventative care that can and does save lives.”

Certain factors played a large part in pregnancy-related deaths, including health problems, inadequate access to appropriate and high-quality care, missed or delayed diagnoses, and lack of knowledge among patients and providers concerning warning signs.

Steps can be taken to help prevent pregnancy-related deaths, the CDC report notes. Doctors can help patients manage chronic conditions and recognize early warning signs. Hospitals can focus on collaboration and improving care before, during, and after pregnancy. Communities and states can address access to housing and transportation for necessary care, as well as focus on developing policies to ensure high risk women receive care at hospitals with specialized heath care providers and equipment.

“Our new analysis underscores the need for access to quality services, risk awareness, and early diagnosis, but it also highlights opportunities for preventing future pregnancy-related deaths,” said Dr. Wanda Barfield, director of the Division of Reproductive Health in CDC’s National Center for Chronic Disease Prevention and Health Promotion. “By identifying and promptly responding to warning signs not just during pregnancy, but even up to a year after delivery, we can save lives.”