Pregnancy-related deaths rose during pandemic, remain elevated for Black women, study finds

Pregnancy-related deaths in the United States increased sharply during the COVID-19 pandemic, with the greatest impact seen among Black women, a new study suggests.

While rates have since returned to pre-pandemic levels for most groups, they remain significantly higher for Black mothers, according to the Michigan Medicine research in Obstetrics & Gynecology.

“We saw a dramatic increase in pregnancy-related deaths during the COVID-19 pandemic, but the recovery has not been equal across all groups,” said senior author Lindsay Admon, M.D., M.Sc., an Associate Professor of Obstetrics and Gynecology at the University of Michigan Medical School and obstetrician-gynecologist at U-M Health Von Voigtlander Women’s Hospital.

“We need to better understand what’s driving these differences so we can develop solutions that reduce maternal deaths and improve outcomes for everyone."

Pandemic drove sharp rise in deaths

The U.S. has long had the highest maternal mortality rate among peer nations, and the COVID-19 pandemic made the crisis worse.

Maternal deaths, defined as those during pregnancy or within 42 days after, rose more than 60% during the pandemic, from about 20 deaths per 100,000 live births in 2019 to 33 in 2021.

From 2018 to 2024, the U.S. reported 8,298 pregnancy-related deaths. Most of the pandemic increase was linked to COVID-19–associated deaths, with early pregnancy deaths rising by 7.5 per 100,000 live births and later pregnancy deaths by 3.7 per 100,000.

By 2023–2024, early pregnancy deaths had returned to pre-pandemic levels, but later postpartum deaths remained elevated.

Recovery varied across groups, with the largest increases among non-Hispanic Black and American Indian or Alaska Native mothers, and older birthing people ages 40–49.

Both early and late pregnancy-related death rates remained notably higher for non-Hispanic Black mothers.

“Our findings show that COVID-19–related deaths drove much of the increase during the pandemic,” Admon said.

“They also highlight persistent racial disparities in maternal deaths. While progress has been made, more work is needed, especially to reduce later postpartum deaths and improve outcomes for Black mothers.”

The study highlights the need to evaluate policies that may influence maternal health, Admon says, including pandemic-era measures such as extended Medicaid coverage under federal relief programs.

“There is an urgent need to understand how both pandemic and post-pandemic policies have affected maternal health,” Admon said.

"This work can help guide public health and policy efforts to reduce pregnancy-related deaths and improve health equity for mothers, children and families.”

Additional authors include Colleen MacCallum-Bridges, Ph.D. and Jamie Daw, Ph.D.

Study Cited: "Recovery of Pregnancy-Related Death Ratios after the Coronavirus Disease 2019 Pandemic," Obstetrics & Gynecology. DOI: 10.1097/AOG.0000000000006255