GAO Report Confirms Worsening of Maternal Health Outcomes, Inequities during the Pandemic

Washington, D.C. – The following is a statement from Maureen G. Phipps, MD, MPH, FACOG, CEO of the American College of Obstetricians and Gynecologists (ACOG):

"The findings from the GAO heighten the concern ACOG has expressed related to the COVID-19 pandemic worsening the U.S. maternal mortality crisis. These new provisional data through 2021 give us cause for serious concern with significant increases in maternal deaths among Black and Latina individuals and an alarming increase in mortality overall when compared with the previous year's data. This report shows that stark racial health inequities that have long been recognized in maternal mortality have been exacerbated during the pandemic.

"Disproportionate rates of mortality among pregnant people of color continued with a dramatic increase in the ratio of deaths related to COVID-19 among pregnant women as the Delta variant became predominant in 2021. Risk of death for pregnant women, according to the report, was more than three times greater during this time period compared with the previous months, and it is no coincidence that at the same time, we faced tremendous disparities in COVID-19 vaccination of pregnant people and challenges in combating vaccine hesitation.

"The fact that COVID-19 accounted for almost the entire increase in maternal deaths in 2021 should send a resounding message to researchers and vaccine developers about the harm of excluding pregnant people from the vaccine development process. That exclusion, which took place despite repeated urging from medical experts, including ACOG, resulted in low vaccination rates among this population and tragically cannot be separated from the increased mortality data provided by this report. Our continued message to all pregnant people is that vaccination is a critical part of prenatal care, not only to prevent death but also to prevent low birth weight and preterm births, which also increased for individuals who tested positive for COVID-19 during pregnancy. Vaccination may occur in any trimester to maximize maternal and fetal health. Additionally, ACOG recommends that everyone, including pregnant people, receive a bivalent mRNA COVID-19 vaccine booster dose two months following the completion of their last COVID-19 primary vaccine dose or monovalent booster.

"Overall, these latest data confirm that there is much more work required to address the many complex factors that lead to poor maternal health outcomes and racial health inequities, including social determinants of health, current and historic inequities in access to health care and other resources, and structural racism. We are committed to using this latest information to inform ACOG's work in understanding and eliminating preventable maternal mortality."