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In-Hospital Maternal Mortality Rates Have Declined by Over 50 Percent

A new study suggests that the nationwide rise in maternal mortality isn’t predominantly linked to in-hospital deliveries but rather pre-and postnatal complications.
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By Wyndi Kappes, Associate Editor
Published June 23, 2023
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Image: Lopolo | Shutterstock

A new study published in the Journal of the American Medical Association is shedding more light on the US maternal mortality crisis.

The study, which analyzed over 11.6 million delivery-related hospitalizations, reveals a significant decrease in in-hospital maternal mortality despite the overall increase in the country’s maternal mortality rate. From 2008 to 2021, in-hospital maternal deaths decreased by over 50 percent, dropping from 10.6 per 100,000 patient discharges in the first quarter of 2008 to 4.6 deaths in the fourth quarter of 2021.

While still a significant part of America’s maternal mortality crisis, seemingly the biggest issue lies not with hospital deliveries but rather with pre-and postnatal complications. According to the Centers for Disease Control (CDC), an estimated 53 percent of maternal deaths occur within seven to 365 days postpartum, with an estimated 80 percent of these deaths considered preventable.

Despite the persistent issue of a maternal mortality rate nearly three times higher for Black women compared to white women, there has been an overall decrease in in-hospital maternal mortality among women of color. Notably, mortality rates have decreased by 92 percent for American Indian women, 73 percent for Asian women, 76 percent for Black women, 60 percent for Hispanic women, 79 percent for Pacific Islander women, and 40 percent for white women.

The US Department of Health and Human Services (HHS) sees this decrease across all racial and ethnic groups as an encouraging sign that both national and local strategies aimed at addressing racial disparities in hospitals are having a positive impact.

Racial disparities are still glaring when it comes to prenatal and postpartum complications. The study reveals an increasing trend in severe maternal morbidity (SMM) for all racial and ethnic groups from 2008 to 2021. Generally defined as serious pregnancy-related complications that have significant consequences to a woman’s overall short and long-term health, the highest overall rates of SMM were observed in Asian, American Indian and Pacific Islander women.

Racial and ethnic minority patients across all ages experienced higher increases in common SMM delivery-related complications from disseminated intravascular coagulation to acute respiratory distress syndrome, sepsis and eclampsia. These complications can easily escalate during the postpartum period, potentially leading to fatal outcomes.

So what can be done? The HHS says they are committed to “improving health outcomes before, during, and after pregnancy,” by identifying significant risk factors that might lead to these complications and supporting better access to improved pre-and postnatal care.

Learn more about how you can personally advocate for better prenatal and postnatal care for all mothers by visiting EveryMotherCounts.org, MarchofDimes.org and Urban.org.

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