Deaths of new and expecting Missouri mothers spiked in recent years. Here’s why
Missouri’s maternal mortality rate saw a 65% increase from 2019 to 2021, during the peak of the COVID-19 pandemic.
Missouri’s maternal mortality rate peaked at 43.3 deaths per 100,000 live births in 2020. This was higher than the United States’ 23.8 deaths that year.
While the Missouri Department of Health and Senior Services hasn’t yet published a maternal mortality report that analyzes how COVID-19 affected its maternal mortality rate, the U.S. Government Accountability Office published a report in October 2022 that found COVID-19 contributed to 25% of the country’s maternal deaths in 2020 and 2021.
The GAO report concluded that the pandemic worsened social determinants of health, including access to health care, transportation access, living conditions and employment.
The health risks of pregnancy and birthing have historically had a disproportionate impact on women of color, in part due to those social determinants of health. A report on maternal deaths between 2018 and 2020 showed Black women in Missouri were three times more likely to die within a year of pregnancy than white women.
How is maternal mortality defined?
The World Health Organization defines maternal deaths as the death of a woman while pregnant or within 42 days of the termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes, such as a car accident or drug overdose. The maternal mortality rate is the number of maternal deaths per 100,000 live births.
But quantifying maternal mortality can be complicated, and not all experts agree on the best way to do it.
A 2024 study published in the American Journal of Obstetrics and Gynecology suggests a much lower national maternal mortality rate — 10.4 deaths per 100,000 live births from 2018 to 2021 — than the CDC’s 32.9 deaths in 2021.
The CDC’s potentially inflated number comes from the addition in 2003 of a pregnancy checkbox to the national death certificate. CDC analysts published a report in 2020 acknowledging that the checkbox may have led to the misclassification of some deaths as maternal deaths.
However, a CDC spokesperson told NPR in a written statement that the CDC disagrees with the study’s findings and believes that the methods used by the researchers led to a “substantial undercount of maternal mortality.”