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July 11, 2024 Story by: Editor
As the Biden administration’s leading advocate for reproductive rights, Vice President Kamala Harris has been outspoken about the shortcomings of U.S. reproductive healthcare and its frequent failures for women of color. Harris has traveled across the country, criticizing state abortion bans and promoting the administration’s efforts to expand postpartum coverage.
During a conversation at the Essence Festival of Culture on July 6, Harris highlighted that Black women face the highest maternal mortality rates in the country. “Black women in the United States of America are three to four times more likely to die in connection with childbirth than other women,” Harris stated at the New Orleans event. “And we know that there are a variety of reasons for that. But we also know that this is a health care crisis of the highest order that has received very little attention proportionate to the seriousness of the matter.”
Harris has previously addressed this issue, pointing out that the U.S. has the highest maternal mortality rate among wealthy nations. She reiterated this claim on July 10, during a speech to Alpha Kappa Alpha sorority members in Dallas.
In 2022, we rated a similar statement about the racial disparities in maternal mortality by Sen. Raphael Warnock, D-Ga., as Mostly True. Warnock noted that the disparity existed even when Black women had insurance and income, but we couldn’t find studies that controlled for those factors.
Given the recent discussion, we consulted new data to verify whether these numbers still hold. They do. The U.S. has consistently had the highest maternal mortality rate among comparable countries. Black women in the U.S. continue to experience higher rates—typically between two to four times higher—than other demographics.
Munira Gunja, a senior researcher at the Commonwealth Fund, a healthcare research organization, called the disparity “unacceptably high.” “No matter what methodology you use, for Black women it’s much higher,” Gunja said. “And the majority of these deaths are preventable.”
Comparing maternal mortality data is complicated due to changes in U.S. measurement methods and different reporting practices in other countries. However, experts agree that the U.S. rate is excessively high and remains so even when adjusting the data.
Eugene Declercq, a community health sciences professor at Boston University who runs the birth data website Birth By the Numbers, noted efforts to improve data consistency across countries. While data comes from different vital statistics systems, they are fairly comparable. “There may be individual instances of underreporting in other countries, but most have data systems as good or better than the U.S.,” he said. “The issue around measurement doesn’t get the U.S.’ poor performance off the hook.”
Maternal mortality data in the U.S. is collected and reported through various systems, primarily the CDC’s National Vital Statistics System and its Pregnancy Related Mortality System. In 2003, the U.S. updated how it measured maternal mortality by adding the “pregnancy checkbox” to death certificates, indicating whether the person was pregnant or recently pregnant at the time of death. This change, gradually adopted by states until 2017, helped record more deaths that were previously missed, though it also logged more misclassifications, increasing reported rates.
Despite the spike in reported deaths due to these methodology changes, experts believe it provided a more accurate reflection of maternal mortality. In a June analysis comparing the U.S. with other countries, Gunja and her team used data from the Organization for Economic Co-operation and Development (OECD), which standardizes data for more accurate international comparisons. “Of course, there are limitations to international comparisons, but the OECD is using a standardized methodology across countries, so there’s no doubt that the U.S. is doing worse,” Gunja said.
Saloni Dattani, a researcher at Our World in Data, affirmed that Black women in the U.S. have around three times the maternal mortality rates of non-Hispanic white women, with or without the measurement change.
In 2022, 817 women in the U.S. died of maternal causes—a rate of 22.3 maternal deaths per 100,000 live births, according to data released by the CDC’s National Center for Health Statistics. This represents a decline from 1,205 deaths in 2021, a rate of 32.9 maternal deaths per 100,000 live births. The most recent data from the Pregnancy Mortality System is from 2020.
Public health experts were not entirely surprised by the decline, noting that maternal-related deaths spiked in 2021 due to the COVID-19 pandemic, which adversely affected pregnant patients. The death rate for Black women in 2022 was 49.5 per 100,000 live births, about three times higher than the combined 16.3 average for other women (non-Hispanic white, Hispanic, and Asian American).
Several factors contribute to the high maternal mortality rate and racial disparity in the U.S., including a lack of universal healthcare coverage, no federal guaranteed parental leave policy, and less robust postpartum care. The U.S. has fewer midwives and OB-GYNs than many other wealthy nations, with about 16 providers per 1,000 live births. Nearly 7 million women in the U.S. live in counties without hospitals or birth centers offering obstetric care and no obstetric providers, with the shortage expected to worsen in coming years.
Data shows that Black patients receive lower quality care than white patients and face racial disparities in hospitals, often rooted in discrimination and clinician bias. A CDC analysis from 2017 to 2019 found that over 80% of pregnancy-related deaths were preventable, with leading causes including mental health issues, excessive bleeding, and cardiac conditions.
The lack of universal maternal care disproportionately impacts Black women. For example, most women in the U.S. have only a single postpartum checkup at six weeks, a critical period when many maternal deaths occur. Some women without childcare or paid leave may miss this appointment.
Our ruling: Harris said Black women are “three to four times” more likely to die in connection with childbirth than other women. Data consistently shows that Black women in the U.S. are around three times more likely to die from pregnancy-related causes than other women. In 2022, Black women experienced a death rate of 49.5 per 100,000 births, compared with a 16.3 combined average for other demographics. Source: PolitiFact
