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Maternal1 deaths in the U.S. spiked2 in 2021, CDC reports
In 2021, the U.S. had one of the worst rates of maternal mortality in the country's history, according to a new report from the Centers for Disease Control and Prevention. The report found that 1,205 people died of maternal causes in the U.S. in 2021. That represents a 40% increase from the previous year.
These are deaths that take place during pregnancy4 or within 42 days following delivery, according to the World Health Organization.
The U.S. rate for 2021 was 32.9 maternal deaths per 100,000 live births, which is more than ten times the estimated rates of some other high income countries, including Australia, Austria, Israel, Japan and Spain which all hovered5 between 2 and 3 deaths per 100,000 in 2020.
According to data from the World Health Organization, the maternal mortality rate in high-income nations overall was 12 per 100,000 live births in 2020, while in low-income countries it was 430 per 100,000.
International comparisons of maternal deaths are difficult because of differences in methodology in tracking the data, warns the author of the new U.S. report, Donna Hoyert, a health scientist at the National Center for Health Statistics, at the CDC. But, she notes, the U.S. is "usually not faring all that well" on maternal mortality.
"There is just no reason for a rich country to have poor maternal mortality," says Eileen Crimmins, professor of gerontology at the University of Southern California. The CDC's latest compilation6 of data from state committees that review these deaths found that 84% of pregnancy-related deaths in the U.S. were preventable.
The increase in maternal mortality in 2021 was "seen broadly across different age groups and race and Hispanic-origin groups," says Hoyert.
She connects the increase in maternal deaths to the COVID-19 pandemic.
"We had some forewarning with the increase between 2019 and 2020 that it looked like maternal mortality rates were increasing during this pandemic period," she says. "With the overall COVID deaths that occurred in 2021, there was a shift towards younger people, so those would be in the age groups where people would be more likely to be pregnant or recently pregnant."
She says provisional data suggest the deaths peaked in 2021 and started to go down last year. "So hopefully that's the apex," Hoyert says.
Yet some experts worry that other trends around the country could make these figures worse, not better, including abortion8 restrictions9 that can delay care for pregnancy complications, and staffing problems at hospitals and closures of rural maternity10 wards7.
The maternal death rate among Black Americans is much higher than other racial groups; in 2021 it was 69.9 per 100,000, which is 2.6 times higher than the rate for White women.
Dr. Veronica Gillispie-Bell, an OB-GYN at Ochsner Health in Louisiana who works with the state's health department to investigate maternal deaths, says social factors, not biological ones, fuel the racial gap. "We have to address the social factors that either are barriers to accessing care or that make your medical conditions worse coming into the pregnancy," she says. "This is not just about doctors in the hospital."
Louisiana is among a group of states working with the Centers for Disease Control and Prevention to improve processes in the health care system to prevent maternal deaths and reduce racial disparities. Gillispie-Bell says she's optimistic the efforts will pay off, but "it's not something that happens overnight. It's going to be a while before we see the benefits of that change."
Change can't come soon enough for families whose lives are affected11. Wanda Irving's daughter died from complications of high blood pressure just three weeks after giving birth to a baby girl in 2017. Irving, who has spoken to NPR in the past about her daughter, now runs an organization called Dr. Shalon's Maternal Action Project to raise awareness12 of the risks for Black mothers in particular.
Irving's daughter, Shalon Irving, was an accomplished13 scientist, working as an epidemiologist at the CDC in Atlanta.
Wanda Irving tears up talking about her daughter's final weeks. "She had gained 9 pounds in that last week. She was having headaches. One leg was bigger than the other and she said, 'There's something dreadfully wrong, can you please check.' "
But she kept getting sent home from the hospital even though she was insistent14 that she needed medical attention. About three weeks after she gave birth, she collapsed15 at home, and never woke up.
Wanda Irving says her daughter's death was preventable – she attributes it to racism16 within the health care system, to doctors ignoring her daughter's symptoms and health risks.
Irving now lives in her daughter's house and is raising her granddaughter, who's now 6 years old, and bright, but struggles with her loss.
"There are days where she totally loses it and she breaks down and she's in tears," Irving says, saying her granddaughter will explain why she's crying by saying, 'I want my mommy. Can I die to go see my mommy?' "
Irving is working to raise awareness of the toll17 of maternal mortality, she says, because she doesn't want another little girl or a little boy to grow up without their mother's love.
"People need to understand the tremendous devastation18 that is caused by maternal mortality and the loss to society as well as to the families," she says.
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1
maternal
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| adj.母亲的，母亲般的，母系的，母方的 | |
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spiked
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| adj.有穗的；成锥形的；有尖顶的 | |
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transcript
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| n.抄本，誊本，副本，肄业证书 | |
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pregnancy
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| n.怀孕，怀孕期 | |
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hovered
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| 鸟( hover的过去式和过去分词 )； 靠近（某事物）； （人）徘徊； 犹豫 | |
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compilation
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| n.编译，编辑 | |
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wards
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| 区( ward的名词复数 )； 病房； 受监护的未成年者； 被人照顾或控制的状态 | |
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abortion
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| n.流产，堕胎 | |
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restrictions
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| 约束( restriction的名词复数 )； 管制； 制约因素； 带限制性的条件（或规则） | |
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maternity
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| n.母性，母道，妇产科病房；adj.孕妇的，母性的 | |
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affected
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| adj.不自然的，假装的 | |
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awareness
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| n.意识，觉悟，懂事，明智 | |
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accomplished
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| adj.有才艺的；有造诣的；达到了的 | |
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insistent
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| adj.迫切的，坚持的 | |
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collapsed
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| adj.倒塌的 | |
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racism
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| n.民族主义；种族歧视(意识) | |
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toll
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| n.过路(桥)费；损失，伤亡人数；v.敲(钟) | |
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devastation
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| n.毁坏；荒废；极度震惊或悲伤 | |
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