Maternal mortality rates have seen a shocking rise across the United States in recent years, with the state of Georgia being a focal point.
Defined by the Centers for Disease Control and Prevention (CDC) as the death of a woman while pregnant or within 42 days of the termination of pregnancy, maternal mortality has long been a pressing health issue within the U.S.
With a yearly average of 800 maternal deaths, the country possesses one of the highest rates of the phenomenon among all developed nations, with it having doubled since the late 1980s.
The national rate alarmingly spiked during the COVID-19 pandemic, soaring to a record-high of 32.9 deaths per 100,000 live births (1,222 deaths in total) during 2021, according to data from the National Center for Health Statistics. This was an increase from a rate of 17.8 per 100,000 live births three years earlier.
The rate within Georgia fared even worse during this period, totaling a staggering 49.2 deaths per 100,000 live births the same year.
Although provisional CDC data from 2024 has indicated that maternal mortality has lowered to pre-pandemic levels nationwide, the crisis persists.
Since late 2023, the national rate has resurged, with that of the state of Georgia continuing to exceed it.
Dr. Kathrine Ingram, a Kennesaw State professor specializing in maternal health, lamented the situation, stating, “Yes, the maternal mortality rate in the United States, and particularly in Georgia, is alarming and devastating for so many families.”
She then elaborated on the risks faced by mothers in regions without access to healthcare, or so-called “healthcare deserts,” explaining, “Because of healthcare deserts, many pregnant individuals must travel over an hour to see a clinician. This impacts their ability to be seen when they need to be seen and to continue their important healthcare checks after birth.”
This results in many women experiencing tremendous health risks both during and after pregnancy in a critical period known as the “fourth trimester”.
Consequently, many mothers fall victim to common and mitigable illnesses both during pregnancy and post-partum. The most widespread include mental health conditions (e.g., post-partum depression.), heart illnesses, and excessive hemorrhages. Hence, according to the CDC, over80% of pregnancy-related deaths in the US are preventable, with the rate being 84% in Georgia from 2019-2021.
Dr. Ingram commented on the importance of medical treatment for pregnant mothers amidst such circumstances saying, “Pregnancy is accompanied by tremendous physiological changes that place large demands on the cardiovascular system. It is very important for pregnant individuals to seek healthcare early in pregnancy and regularly throughout gestation.”
Nonetheless, she did recognize that this was “easier for someone who has good health insurance and reliable transportation,” resources which many women from marginalized groups lack.
This has caused many social disparities within maternal mortality, mainly pertaining to race, with women of minority groups being more susceptible. This has particularly affected African American women, whose rates were over twice as high as the national average in 2021.
Georgia statistics have reflected similar trends, with 54% of pregnancy-related deaths in the state occurring among black women.
Native American women have also been adversely impacted and consistently rank as the most affected group. Widely lacking adequate healthcare access, their maternal mortality rate was 118.7 deaths per 100,000 live births in 2021, nearly four times the national rate.
“The high mortality rate in Georgia disproportionately impacts black and brown communities, as these are hit particularly hard by the healthcare deserts and other challenges that make it difficult to access good healthcare,” Dr. Ingram stated, explaining the implications of such racial disparities.
She additionally noted, “Furthermore, research indicates that racial bias is still an issue in today’s society, and many programs are focused on raising awareness,” suggesting that systemic prejudice also continues to be a salient issue.
Maternal mortality has also variably impacted mothers of different ageswithin Georgia and across the U.S., with those experiencing geriatric pregnancies (pregnancy in older age) being the most vulnerable compared to adolescent and young adult mothers.
These differences are often attributed to the prevalence of chronic illnesses, like hypertension and obesity, among older pregnant women, but the rate remains exceedingly high compared to those of similar age and conditions in other developed countries.
These elements of the crisis indicate the need for extensive maternal care reform across the nation. Though many demographic discrepancies exist, the issue is one that profoundly affects all mothers and women within our healthcare system, and there have thus been numerous efforts to address it.
One key factor has been the surveillance methods government agencies have used to assess maternal mortality. A recent study by the American Journal of Obstetrics and Gynecology concluded that America’s maternal mortality rate has been inflated due to inaccurate data analysis by agencies like the CDC. The research suggests that the peak rate in 2021 was 10 deaths per 100,000 live births and the authors contend that the addition of a pregnancy checkbox on national death certificates led to the extensive misclassification of deaths that were not solely pregnancy related.
Despite being contested by the CDC, the study gained support from numerous medical professionals and continued to highlight many of the racial and health disparities indicated by previous data.
Thus, the improvement of surveillance systems has become a central objective of government agencies to combat the rise in maternal mortality throughout the U.S., and Georgia is no exception. The Georgia Maternal Mortality Review Committee was formed to thoroughly analyze pregnancy-related deaths within the state and better understand the causes of maternal mortality for the purpose of implementing preventative measures and expanding awareness of the issue.
Maternal health advocates and professionals have also stressed the importance of caring for mothers in the 4th trimester, post-partum.
Dr. Ingram supported this approach, citing how this phase is “a particularly vulnerable window after birth,” and how expanding “access to good healthcare by all pregnant individuals, both during and after pregnancy, would be a powerful way to help the maternal mortality crisis.”
The Georgia General Assembly has also taken measures to address the problem, such as through legislation to extend Medicaid coverage for low-income mothers to a maximum of one-year post-partum.
However, the legislature’s efforts have had a modest impact, and it has received criticism for passing laws restricting access to key reproductive health services, like abortion and family planning, even though such restrictions have been proven to increase maternal mortality in several states.
Consequently, maternal mortality continues to be a dire issue within Georgia as, despite its mitigatory efforts, the state has continued to enact policies which exacerbate the crisis.
Nonetheless, Dr. Ingram remained determined, saying, “I would love to see healthcare deserts addressed and for all women to have access to team-based maternal healthcare, with those at higher risk having access to physicians, midwives, and remote patient monitoring for cardiac events. A perfect team would also include other health professionals who can address healthy lifestyle choices during pregnancy, including diet planning and exercise programming.”
As this crisis affects the lives and health of countless mothers across Georgia and the United States, it is largely seen as a matter of healthcare and morality.Dr. Ingram encourages women who are experiencing depression or suicidal thoughts should seek care from their healthcare providers or available mental health hotlines. A new mental health resource to all individuals is the 988 Crisis Lifeline, where callers can contact providers to discuss their situations.
