COVID-19 has widened racial disparities in pregnancy-related deaths from non-obstetric causes in the US

In the United States, several racial and ethnic minority groups have reduced access to quality health care compared to their non-Hispanic white counterparts. Studies have shown that implicit biases among healthcare professionals that stem from unscientific beliefs – such as the belief that black patients experience less pain compared to white patients – lead to mistreatment of minorities when they access healthcare facilities.

A key demographic among minority groups affected by unequal access to emergency health care is pregnant women and new mothers. In a recent study led by Associate Professor Claire E. Margerison: published in the American Journal of Public Healthresearchers found that pregnancy-related death rates from all causes, except suicide, increased during the COVID-19 pandemic in the US. Additionally, researchers also found that pregnancy-related deaths from non-obstetric causes increased disproportionately among Hispanic, Black, American Indian and Alaska Native (AI/AN), and Asian people in 2021, demonstrating a concerning trend.

“Our analysis of national birth and death data from 2018 to 2021 found that in the first year of the COVID-19 pandemic (from 2019 to 2020), pregnancy-related deaths from all causes except suicide (i.e. obstetric causes, drug-related causes) were related to , murder and all other causes combined) increased between 30% and 60%. However, in 2021, obstetric deaths increased another 31%, but other causes of death did not change significantly,” explains Dr. Margerison out.

“These overall numbers mask a disproportionate increase in cause-specific pregnancy-related deaths among minority racial and ethnic groups,” she notes.

The study found that drug-related pregnancy deaths increased disproportionately among Hispanic, non-Hispanic AI/AN, and non-Hispanic Asian people, while homicide deaths increased disproportionately among most racial and ethnic groups. Additionally, their research revealed that pregnancy-related deaths attributed to suicides were alarmingly increasing among Hispanic, AI/AN, and Asian people. The study classified deaths as “pregnancy-related” if the deceased was pregnant at the time of death or shortly before.

“Existing inequities in pregnancy-related deaths may have been influenced by the COVID-19 pandemic as risk factors… including lack of access to preventive care, intimate partner violence, psychosocial stress, unemployment and financial hardship – all increased during the pandemic,” says Dr. Margerison notes.

While the disparity in pregnancy-related deaths from obstetric causes in the US has received attention from the academic and public community, the same continues to happen for deaths during or just before pregnancy from non-obstetric causes. As such, this study provides crucial insights that help better understand an overlooked trend with broad social implications.

“Our findings highlight the need for approaches and interventions to address substance use, mental health and intimate partner violence that center the postpartum experiences of pregnant and postpartum people and that work to break down structural barriers, especially those that have been erected through structural racism and settler colonialism. ‘ underlines Dr. Margerison.

Minority racial and ethnic groups in the U.S. often experience inequities in access to safe housing, transportation, child care, education, and employment. All of these factors affect the health of new and expectant mothers and their ability to access health care, especially during emergencies that pose an immediate danger to their lives.

Overall, the study suggests that in addition to improving access to emergency and non-emergency health care, there is an urgent need to improve basic services to protect pregnant women from non-obstetric causes of death.

Provided by the American Public Health Association