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In the United States, Black-white disparities in maternal mortality—deaths related to pregnancy or childbirth—may be larger than previously reported, new research shows. Closing the gap involves addressing structural racism—that is, those aspects of social, political, economic, and health care systems that reinforce inequity, researchers say.
Because pregnancy is riskier to women’s health than abortion, state initiatives to restrict abortion could lead to more deaths, particularly among Black women, new estimates suggest.
Black Women Five Times More Likely to Die from Pregnancy-Related Cardiomyopathy, Blood Pressure Disorders Than White Women
By thoroughly reexamining death certificates from 2016 and 2017, researchers found that the maternal mortality rate among non-Hispanic Black women was 3.5 times that of non-Hispanic white women.1 This is a dramatic increase from previous analyses, based on standard medical codes, that found that Black women faced a maternal death rate 2.5 times that of white women, according to Marian MacDorman of the Maryland Population Research Center (MPRC) at the University of Maryland, who led the study.
The new analysis also revealed that these disparities were concentrated among a few causes of death. Postpartum cardiomyopathy (a form of heart failure) and the blood pressure disorders preeclampsia and eclampsia were leading causes of maternal death for Black women, with mortality rates five times those of white women. Pregnant and postpartum Black women were also more than two times more likely than white women to die of hemorrhage (severe bleeding) or embolism (blood vessel blockage).
In the researchers’ analysis, embolism and preeclampsia/eclampsia tied for the leading cause of maternal death across all racial and ethnic groups during pregnancy or within six weeks after pregnancy (see figure). These were followed by postpartum cardiomyopathy, hemorrhage, and complications from obstetric surgeries such as cesarean sections.
Among White and Hispanic women, causes of maternal death ranked somewhat similarly. However, for Black women, preeclampsia/eclampsia was the leading cause of maternal death, followed by postpartum cardiomyopathy, embolism, and hemorrhage. Ectopic pregnancy, the fifth leading cause of maternal death for Black women, was not a leading cause for white or Hispanic women.
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New analysis of 2016–2017 death certificates shows non‑Hispanic Black women face 3.5 times the overall maternal mortality of non‑Hispanic white women—and up to five times the risk of death from postpartum cardiomyopathy and hypertensive disorders—evidence that maternal mortality disparities are larger than previously reported and reflect systemic, preventable harms rooted in structural racism that require urgent, targeted health‑care and policy interventions.
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