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The CDC Says Maternal Mortality Rates In The US Got Better, After A Pandemic Spike
After spiking in 2021, the maternal mortality rate in the U.S. improved significantly the following year, according to a new report from the Centers for Disease Control and Prevention..
In LA
In January 2023, April Valentine died at Centinela Hospital. Her daughter was born by emergency C-section. She'd gone into the pregnancy with a plan, knowing Black mothers like herself were at higher risk.
- Read LAist's investigation into Centinela Hospital.
The data shows that 817 women died of maternal causes in the U.S. in 2022, compared to 1,205 in 2021. These are deaths that take place during pregnancy or within 42 days following delivery, according to the World Health Organization, "from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes."
"I think that the bump [in 2021] reflects the pandemic and we're returning to pre-pandemic levels," says study author Donna Hoyert, who a health scientist at the CDC's National Center for Health Statistics.
The maternal mortality rate in 2022 was 22.3 deaths per 100,000 live births. That's a significant decrease from the 2021 rate of 32.9, but it's still much higher than the rate in other wealthy countries.
There continue to be enormous racial disparities in the U.S. maternal mortality rate as well — the rate for Black women was 49.5 deaths per 100,00 births in 2022, compared to a rate of 19 deaths for white women. Research shows the vast majority of these deaths are preventable.
Dr. Veronica Gillispie-Bell is an OB-GYN in New Orleans who was not involved in the CDC report. She agrees that COVID-19 was likely the reason for the major spike in maternal mortality.
"I really think that 2021 was actually an outlier because of the circumstances," Gillispie-Bell says. "We know that because of COVID-19, there were disruptions to care that obviously impacted our ability to care for pregnant individuals, plus there were pregnant individuals who were dying from COVID." It's hard to know for certain since the CDC report did not include cause of death, she adds.
She's encouraged that the 2022 numbers are slightly lower than 2020 — 817 in 2022 versus 861 in 2020. "It could mean that we're moving in the right direction — I think we need more years of data to know," she says.
CDC's newest data comes several weeks after an academic study cast doubt on the agency's methodology, suggesting that a pregnancy checkbox on death certificates was causing the numbers to be much higher than they are in reality. CDC strongly rejected the study's findings.
Hoyert also defends CDC's methodology. "There was plenty of literature before we made the changes that we were underestimating [maternal deaths] without a checkbox, and so we did add the checkbox," she says, explaining that they have continued to do evaluations and issue guidance to ensure it's being used correctly.
"I think CDC is doing great work in collecting the data and sharing that back," CDC Director Mandy Cohen told NPR last month. "We disagree with how that study was looking at it, and think it's unacceptable for moms to be dying at that rate here in the United States."
The stakes for getting these numbers right are high in a post-Roe America. Reproductive health advocates warn that abortion bans threaten women's lives, and if CDC's data is not viewed as reliable by the public, that could make it hard to evaluate the impact of these restrictions.
Dr. Gillispie-Bell says the public should still put a great deal of stock into CDC's analysis. She also pointed to the work of state maternal mortality review committees around the country – she is the medical director of the committee in Louisiana. They are supported and funded by CDC.
"The first step for our maternal mortality review committee — once we get the death certificate with that pregnancy checkbox — is to then start extracting data to confirm ... so our numbers are very accurate," she says.
Not all states have these committees validating maternal deaths and making recommendations to reduce their numbers. CDC Director Cohen pointed out the agency now has funding available for each state. She also pointed out that CDC's data has already led to policy changes to reduce maternal deaths, including allowing Medicaid coverage to continue for a year postpartum.
"I think we're making strides, which is great," Cohen added. "We have more work to do."
Resources
Birth and Postpartum Resources
These resources were recommended by California birth workers and families. Have a suggestion? Email sritoper@scpr.org.
For more on specific topics, see LAist’s pregnancy guides.
Mental Health
- 988 Suicide and Crisis Lifeline - Free and confidential support for people in distress, prevention and crisis resources for you or your loved ones.
- National Maternal Mental Health Hotline - 24-Hour hotline for pregnant and new moms at 1-833-943-5746 (1-833-9-HELP4MOMS).
- Postpartum Support International (PSI) - Free, confidential support before, during, and after pregnancy. Responses within a few minutes 24/7 at 800-944-4PPD (4773).
- Maternal Mental Health NOW - Hosts a directory of providers and services in L.A. County and a self-help tool to help navigate the emotions of the transition to parenthood.
- Therapeutic Play Foundation - a Pasadena-based non-profit created by Black mental health professionals that provides mental health services, support for birthing people and community gatherings.
- All-Options talkline. Process how you feel or what to do next by talking to a volunteer peer-counselor about abortion, adoption, parenting, infertility or pregnancy loss.
Breastfeeding
- BreastfeedLA – Provides education and outreach to promote and support breastfeeding in Southern California. Find resources on their map of local breastfeeding resources.
- CinnaMoms – Support circles for Black birthing people hosted at WIC centers in the L.A. area, with the goal of breaking down barriers to breastfeeding.
- La Leche League – Peer support groups for breastfeeding. Find a local meeting.
- Kellymom – Breastfeeding information site run by international board certified lactation consultant Kelly Bonyata.
- National Women’s Health and Breastfeeding Helpline – Run by the US Department of Health’s Office of Women’s Health, breastfeeding peer counselors are available to talk between 9 a.m. to 6 p.m. ET at 800-994-9662.
- Soul Food For Your Baby – Black-led breastfeeding support groups.
Doulas / Postpartum Support
Doulas provide expecting and new mothers or birthing people with educational, emotional, and physical support before, during, and after a baby is born. Postpartum doulas’ services can include cooking, help around the house, and various healing modalities. Pro tip: many postpartum doulas are available pro-bono while they are seeking certification.
- What Do Doulas Do? – LAist’s guide to doulas, including a list of resources to find a doula in Southern California.
- Birthworkers of Color Collective – A collective of birth workers of color providing trainings, workshops, and healing offerings for birthworkers, pregnant people, and their families.
- DONA International – Doula certifying organization that includes a search tool to find prenatal and postpartum doulas.
Support Groups
Many support groups and parent and me classes exist throughout Southern California, and the best way to find one is to search online for groups in your area. You might also find these groups through your hospital or places where you find breastfeeding gear. It sometimes helps to look for activities you enjoy (eg. yoga, swimming, dancing) and see if they have “baby and me” classes.
A few places to start:
- Kindred Space – A hub for midwifery care, doula support, lactation consulting and support groups.
- LOOM – Provides pregnancy, breastfeeding classes, and a doula directory.
- Lucie’s List – Map of local parent groups.
- Pump Station – Baby supply store that also offers parent and me classes.
For Black Parents-to-Be
- What Pregnant Black Women Need To Know To Have A 'Safe And Sacred Birth' – LAist’s guide for Black birthing people.
- AAIMM Doula Program – LA County Department of Public Health runs a program offering free birth doulas to Black birthing people.
- Black Emotional and Mental Health Collective (BEAM) – A national organization focused on Black emotional health care and healing that offers peer support groups, trainings, and grants.
- Black Infants & Families Los Angeles – A multifaceted Department of Public Health initiative that runs a program offering free doulas to Black birthing people. There are also Antelope Valley, South L.A./South Bay, San Gabriel Valley and San Fernando Valley/Santa Clarita- based groups that meet to discuss how to end Black infant and maternal deaths and share resources.
- Parenting For Liberation – a virtual community founded by an Orange County mom that “connects, inspires, and uplifts Black folks as they navigate and negotiate raising Black children within the social and political context of the U.S.”
- Sugar Heal Gang – A collection of Black healers who provides grants through their Black Maternal Health Fund to cover maternity care services.
- The Victoria Project – A fund for birth care outside of a hospital setting (home birth & birth center) to families within Los Angeles, Ventura, and Santa Barbara counties.
- Black Mental Health Task Force— a coalition of California mental health professionals, community organizations and residents focused on supporting “mental health wellness within the African American community.”
- Black Women For Wellness— An LA- and Stockton-based nonprofit focused on health education and advocacy
For Partners / Fathers
- Black Daddy Dialogues – Support group for dads raising Black children, every second Saturday of the month.
- Love Dad – Home visits to fathers and their children throughout L.A. County
- The Expecting Fathers Group for Black Dads – Support group for Black soon-to-be fathers and provides education, support and navigation tools for the prenatal, labor and delivery, postpartum, and early parenting.
Loss / Grief
- 'Just Try Again' And Other Things Not To Say - LAist reporting on miscarriage and loss, including a list of local and national support resources.
- Compassionate Friends – Support for parents dealing with loss.
- L.A. County Grief Support Resources – A list of resources for parents and families dealing with infant and fetal loss, service planning area (SPA).
- MISS Foundation – 24/7 online crisis support and long term aid to families after the death of a child from any cause.
- Open Path Collective – Sliding scale therapy.
- Our House Grief Support Center – Open to the community. Fee based on a sliding scale.
- Sisters in Loss – Doula Erica M. Freeman is dedicated to “replacing silence with storytelling around pregnancy and infant loss and infertility of Black women” and hosts a podcast and a virtual support community.
Social Services
- 211 – Information and referrals for all health and human services in LA County, including a query for “parent programs.”
- Home Visiting Programs – L.A. County has several free programs with home-based visits to support families with new babies, available depending on hospital, zip codes, and other criteria. First 5 LA gives an overview of the “Welcome Baby” program and participating hospitals. Look up which home visiting programs you might qualify for in the L.A. County home visiting program directory.
- PHFE WIC – Breastfeeding support, healthy foods, and connections to additional financial and social support services for low-income parents.
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