Another recent study, Trends in State-Level Maternal Mortality by Racial and Ethnic Group in the United States published in JAMA, has provided data showing that maternal health outcomes in the United States are worsening despite state and national interventions to decrease maternal mortality.

The analyzed data from 1999 to 2019 showed that American Indian, Alaskan Native, and Black women have the highest maternal mortality ratios (MMRs) of all ethnic groups in the United States and that these numbers increased over the aforementioned twenty years. Black mortality, the race with the highest mortality rates across all years, was largely clustered in the South, especially in Georgia and Mississippi in 2019. The South, in fact, accounted for the vast majority of Black maternal deaths with 245, far more than any other region even though New York and New Jersey also saw increased MMRs. American Indian and Alaska Native MMRs were highest in the Midwest and West. And Asian, Native Hawaiian, and Pacific Islanders have clustered deaths in the South and West. 

It is important to note that all races and ethnicities saw an increase in MMRs over the two decades between 1999 and 2019. This, surprisingly, is not because of a comparably increased number of births. In fact, there were an estimated 216,100 fewer births in the United States in 2019 than in 1999. White and Hispanic women had the lowest MMRs. The researchers acknowledge that the Hispanic and White populations typically have increased pregnancy-related deaths that are caused by suicide and overdoses though they do not account for that in the study due to coding on death certificates. They acknowledge that this may contribute to some of the decreased MMRs.

The researchers also mention five limitations to their data including coding on death certificates and the correct identification of race. And, the study also states that individual states’ review committees acknowledge that these deaths are largely preventable and can use this data to establish patterns of maternal mortality.