The Supreme Court decision overturning abortion rights may lead to still more maternal deaths, by further limiting access to reproductive care in the United States. The concern is particularly acute in states like Mississippi, which have among the highest rates of maternal deaths in the country and have enacted near total bans on abortion.
Research is underway to better understand why the deadly racial disparity persists, and how to close it. But plenty is already known about how to reduce deaths from childbirth and pregnancy in general. Yet the United States seems to have accepted these deaths, failing to widely carry out measures that have been shown to stop them.
Researchers, medical professionals and advocates say the United States should adopt best practices similar to those deployed in states like California, which according to federal data has the lowest rate of maternal deaths in the country; focus on improving the health care received by American women — but especially Black and Native women — during pregnancy and delivery, and up to a year after; and enhancing the social services offered to pregnant women, from transportation to housing.
The California Model
One way forward is to take a close look at how California made progress.
California’s maternal mortality rate surged during the pandemic, a trend seen across the country. But in the years before Covid hit, the state had significant success in reducing its maternal mortality, lowering it to 12.8 deaths per 100,000 births. That is still higher than in many developed countries, but significantly under the national rate of 20.1 deaths for every 100,000 births in 2019. Though the racial disparities persist in California, as in the rest of the country, it had, before Covid, narrowed that gap.
The state has been working on this issue for more than a decade. In 2006, its Department of Health began investigating maternal deaths, which were on the rise in the state. The same year, it began a public-private partnership with Stanford University, known as the California Maternal Quality Care Collaborative, aimed at reducing the deaths. Nearly every hospital in the state belongs to the group. Membership includes benefits, like financial bonuses for reducing C-section rates, and responsibilities, like sharing data with other members.