Pregnancy-related Deaths

Pregnancy-related deaths spiked during the pandemic, and pregnancy-related death rates for Black and American Indian people remain 2-3 times higher than for other groups.

Pregnancy-related deaths, U.S.

1999-2022

Sources: CDC, Wonder Mortality Data (deaths) and CDC, Wonder Natality Data (births). Notes: AN= Alaska Native. 2022 data is provisional (p). A pregnancy-related death is defined as a death while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. Pregnancy-related deaths are identified using ICD–10 underlying cause-of-death codes: A34, O00–O95, and O98–O99.

Pregnant people are some of the most vulnerable in society, and growing research shows that they face heightened vulnerability due to climate change impacts. Heat exposure, diseases from contaminated water, and respiratory issues are among several potential risks that can cause higher rates of pregnancy-related illnesses such as anemia, (pre)eclampsia, low birth weight, preterm birth, and miscarriage (FEMA Disaster Declarations, Extreme heat days, Heat Vulnerability, Black Carbon, Flood Risk).^1,2,3

In 2020 and 2021, pregnancy-related deaths spiked in the U.S., jumping from 20 deaths per 100,000 live births in 2019 (754 overall deaths) to 33 per 100,000 live births in 2021 (1,205 overall deaths). According to GAO estimates, 25% of pregnancy-related deaths that occurred in 2020 and 2021 listed Covid as a contributing cause of death.⁴ Provisional data for 2022 shows that pregnancy-related deaths decreased to 22 per 100,000 live births (819 overall deaths). Still, pregnancy-related deaths in the U.S. remain higher than pre-Covid in 2019 and have more than doubled since 1999, with both the Black and American Indian and Alaska Native populations at increased risk.⁵ Black and Indigenous people have historically faced racial discrimination, bias, and inequity in health care systems, for pregnancy-related and other care.^{[6],[7],[8],[9],[10],[11],[12]}

In addition to addressing systemic racism in health care, increasing air filtration in areas that experience wildfires frequently, or offering doctor’s appointments in the evening for areas that have high heat exposure, are among practices that can help reduce the impacts of climate change on pregnant people and reduce pregnancy-related deaths.²

1. Climate Change and the Health of Pregnant, Breastfeeding, and Postpartum Women. (2022, March 21). U.S. Environmental Protection Agency. https://www.epa.gov/climateimpacts/climate-change-and-health-pregnant-breastfeeding-and-postpartum-women

2. Ha, S. (2022). The Changing Climate and Pregnancy Health. Current Environmental Health Reports, 9(2), 263–275. https://doi.org/10.1007/s40572-022-00345-9

3. Rylander, C., Øyvind Odland, J., & Manning Sandanger, T. (2013). Climate change and the potential effects on maternal and pregnancy outcomes: an assessment of the most vulnerable – the mother, fetus, and newborn child. Global Health Action, 6(1). https://doi.org/10.3402/gha.v6i0.19538

4. U.S. Government Accountability Office. (2022, October 19). Maternal Health: Outcomes Worsened and Disparities Persisted During the Pandemic. https://www.gao.gov/products/gao-23-105871

5. Fleszar, L. G., Bryant, A. S., Johnson, C. O., Blacker, B. F., Aravkin, A., Baumann, M., Dwyer-Lindgren, L., Kelly, Y. O., Maass, K., Zheng, P., & Roth, G. A. (2023). Trends in State-Level Maternal Mortality by Racial and Ethnic Group in the United States. JAMA, 330(1), 52–61. https://doi.org/10.1001/jama.2023.9043

6. Chinn, J. J., Martin, I. K., & Redmond, N. (2020). Health equity among black women in the united states. Journal of Women’s Health, 30(2), 212–219. https://doi.org/10.1089/jwh.2020.8868

7. Bridges, K. (2015). Implicit bias and racial disparities in health care. American Bar Association. https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/racial-disparities-in-health-care/

8. Pillai, D., & Artiga, S. (2022, November 10). Health and Health Care for Indigenous People. KFF. https://www.kff.org/racial-equity-and-health-policy/slide/health-and-health-care-for-indigenous-people/

9. Wallace, A. A., & Bell, A. M. (2020, October 16). Race and Medicine: How Modern Medicine Has Been Fueled by Racism. Healthline. https://www.healthline.com/health/modern-medicine-fueled-by-racism

10. Disparities and Resilience among AIAN People. (2023, March 29). U.S. Centers for Disease Control and Prevention. https://www.cdc.gov/hearher/aian/disparities.html

11. Working together to reduce black maternal mortality. (2023, April 3). U.S. Centers for Disease Control and Prevention. https://www.cdc.gov/healthequity/features/maternal-mortality/index.html

12. United Nations Population Fund. (2023). Maternal Health of Women and Girls of African Descent in the Americas Analysis. https://www.unfpa.org/sites/default/files/resource-pdf/UNFPA_MM_Analysis-July2023.pdf