The maternal death rate in the United States increased by almost 20% in 2020, the highest among the 10 economically developed countries. The World Health Organization defines maternal death as the death of a woman from any cause related to or aggravated by the pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days (about 1 and a half months) of termination of pregnancy, irrespective of the duration and site of the pregnancy.
The CDC recently reported that in 2020, 861 women were identified as having died of maternal causes in the United States compared to 754 in 2019. In 2019 the maternal death rate in Florida was at its highest at 28.6 and in 2020 it dipped to 13.4.
In 2020 the maternal death rate was higher in Miami-Dade County with a 21.7 maternal death rate in comparison to the entire state of Florida. Miami-Dade is matching the national increase rate.
Nationally, maternal death rates are high among Hispanic and Black women. In 2020, the maternal mortality rate for non-Hispanic black women was 55.3 per 100,000 live births, 2.9 times the rate for non-Hispanic White women which was 19.1, and more than three times the rate for Hispanic women with an 18.2 mortality rate. From 2019-2020 for non-Hispanic White women, the increase in maternal death ratios overall was not significant. For Miami-Dade, the maternal death ratios were the same as those nationally. In 2020 the maternal mortality rate for Black and other non-White races was 51.1 in comparison to White women with a 14.2 rate, which is a 36.9 rate difference. This difference between races is due to a lack of prenatal care and socioeconomic status.
The three leading medical causes of maternal mortality in the United States are blood clots in the lung, hypertension (high blood pressure), and blood loss. There is no clear explanation as to why women are dying from these three medical conditions while giving birth or after. The Racial and Gender Discrimination In US Health Care spoke to black women in Atlanta, Georgia, and Jackson, Mississippi, and found wide gaps in information about sexuality and sexual health and access to services. They found that racial discrimination is very real in the healthcare system. This is one of the causes of this high maternal death rate nationwide and it could be true in Miami-Dade as well since the number reflects the same as the national ratios. The Women’s Fund’s Gender Equity Dashboard has also highlighted the discrepancies at a local level. Black women in Miami-Dade not only have the highest maternal mortality rate but the highest infant mortality rate. As well as having the lowest adequate prenatal care at 69.3 per 100,000 people in Miami-Dade County.
The demographics of childbirth are also changing, meaning women are having children later in life resulting in a high-risk pregnancy that leads to complications and possibly death. Some women are also entering pregnancies with chronic conditions such as hypertension, obesity, diabetes, and cardiovascular disease. In addition, there’s a rising number of Cesarean Sections which is not always necessary and is believed to be a contributor to these high maternal death rates. 2020 was still the height of the pandemic and the unemployment rate across the nation and in Miami was high. With the unemployment rate being so high many women probably didn’t have the right health care coverage which could have been another factor as to why the maternal death rate increased significantly. In order to reduce this death rate technical and administrative changes need to take place in the health care system across the country and at a state and local level.