Jul 6, 2023 - Health

Study: Mothers are dying more often – especially if they're Indigenous

Data: Institute for Health Metrics and Evaluation; Map: Tory Lysik/Axios Visuals

Maternal mortality rates nationwide have risen across racial and ethnic groups over the past two decades, according to a new study co-authored by researchers at the Seattle-based Institute for Health Metrics and Evaluation.

  • The increase is especially notable among Indigenous women, including in Washington state — although white mothers saw a big increase in deaths as well, one of the lead authors told Axios Seattle.

Why it matters: Researchers say most maternal deaths are preventable, yet the United States has one of the highest rates of such deaths among high-income countries.

Details: The study, published this month in the Journal of the American Medical Association, provides the first state-by-state breakdowns of maternal mortality rates by ethnic group, Axios' Oriana González reported.

Zoom in: In Washington state, the maternal death rate among American Indians and Alaska Natives spiked by 71% when comparing 1999-2009 to 2010-2019, rising from 21.5 deaths per 100,000 live births to 36.8 deaths per 100,000 live births, per the study.

  • White women saw an estimated 53% increase in maternal deaths over the same period, with the death rate rising from 13.6 per 100,000 to 20.8 per 100,000.

What they're saying: "What stood out to us was that maternal mortality did not improve for any racial and ethnic groups," Laura Fleszar, a researcher at the University of Washington's Institute for Health Metrics and Evaluation and a lead author of the study, told Axios Seattle.

  • Besides the stark increase among American Indians and Alaska Natives, other takeaways were that Black individuals consistently experienced higher maternal mortality rates nationwide, she added.

Between the lines: Among states, Fleszar described Washington state as "middle-of the-pack for overall maternal mortality."

  • "But since these deaths are mostly preventable, there is still room for improvement," both here and across the U.S., she said.

The big picture: Nationwide maternal mortality rates more than doubled between 1999 and 2019, with states in the Midwest, Great Plains and South accounting for significant increases.

  • Overall, there were an estimated 1,210 U.S. maternal deaths in 2019, compared to 505 in 1999.
  • Maternal mortality is defined as a death that takes place during birth or up to a year later.
  • The study looked at pregnant individuals aged 10 to 54.

What we're watching: Fleszar said the research team hopes their work prompts clinicians and policymakers to "continue investigating the reasons behind these trends and the interventions to address them."

  • Already, Washington state's health department is recommending expanding access to midwives, doulas and home-visiting services for new mothers; increasing diversity among health care workers; and boosting funding for rural and tribal clinics as ways to improve maternal health.

Go deeper: Maternal deaths widespread beyond the South


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