Washington, D.C. – The following is a statement from Iffath Abbasi Hoskins, MD, FACOG, president of the American College of Obstetricians and Gynecologists (ACOG):
“The data released Monday by the CDC show that a much larger percentage of U.S. maternal deaths than previously reported were deemed to be preventable. The current report, representing data from 36 states, demonstrates that we have much more work to do to effectively address the underlying causes of maternal mortality in order to save the lives of pregnant and postpartum patients.
“This analysis, using the CDC’s Enhancing Reviews and Surveillance to Eliminate Maternal Mortality Program, found that over 80% of maternal deaths were determined to be potentially preventable. This is much higher than the 60% reported in previous CDC data released in 2019 from 13 state maternal mortality review committees.
“This latest report has limitations, but it moves us closer to the standardization of maternal mortality data and underscores how important it is to understand the complex factors—systemic, institutional, community, and clinician-specific—that affect the underlying causes of maternal mortality.
“Notably, for the first time, mental health conditions were a leading underlying cause of pregnancy-related deaths, which was reflective of the largest number of deaths among white, Hispanic, and American Indian or Alaska Native populations.
“These results demonstrate the impact that mental health issues have on our patients’ lives and that mental illness can be deadly. ACOG's Minding Mental Health campaign is predicated on the urgent need to raise awareness about perinatal mental health and the imperative to dedicate national and local resources for education, outreach, and treatment to combat this crisis and improve outcomes.
“Importantly, the data showed that the leading cause of death for Black pregnant and postpartum people is cardiac and coronary conditions, followed by cardiomyopathy. It is essential to understand the conditions that specifically affect Black pregnant and postpartum individuals. However, it is the rate of maternal deaths—not included in this report—that indicate that this population is three times more likely than white counterparts to die from pregnancy-related complications, making it necessary to evaluate data using a health equity and racial lens. This is how we will be able to inform focused solutions that will eliminate inequities in care and outcomes that exist for Black pregnant and postpartum people.
“The report also highlights that 53% of pregnancy-related deaths occurred from seven days after delivery to one year postpartum, much higher than the 33% reported by the CDC a few years prior, emphasizing the importance of health care during the postpartum period.
“ACOG has spent years advocating for postpartum Medicaid extension and was a leading voice in advocating for the additional pathway for extending this coverage for pregnant people from 60 days to one year postpartum through the American Rescue Plan Act. Currently, more than half of states have extended Medicaid coverage in some form through this option and other pathways. The CDC data reinforce that extending postpartum Medicaid coverage is sound policy, and states that have not done so are missing an opportunity to save lives.
“Pregnancy is a complex, physiologically and mentally demanding process, which may cause great stress to the pregnant person. We cannot consider these data without acknowledging that people around the country are losing their rights to end a pregnancy. Because of unscientific abortion restrictions and bans, people will be forced to continue pregnancies in a country in which preventable maternal deaths are increasing. In fact, state abortion bans specifically prevent the granting of medical exceptions for mental illness, despite the clear threat posed by mental illness during pregnancy.
“As an organization representing obstetrician–gynecologists across the country, ACOG will use this information to inform our work in supporting pregnant and postpartum people, changing the culture of medicine in order to eliminate preventable maternal mortality and racial health inequities in birthing outcomes, and fighting for the ability of our patients to be able to choose whether or not to be pregnant.”