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.
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 100,000 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.
In a statement about CDC's latest report, Dr. Verda Hicks, president of the American College of Obstetricians and Gynecologists, connected the maternal mortality figures to "the worsening state of reproductive health care since the Dobbs decision."
"When treating pregnancy complications, abortion care can be lifesaving, and withholding that care unquestionably compromises patient lives and outcomes," Hicks wrote.
Despite the challenges with the data, Dr. Gillispie-Bell says the public should still put a "great bit 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."
