Pregnancy-related deaths increased nearly 70% in California. What caused the spike?

California has historically had one of the lowest pregnancy-related mortality rates in the country.

However, the Golden State saw a 68.8% increase in deaths involving pregnant or recently pregnant women from 2019 to 2021, according to state data.

The spike came during the peak of the COVID-19 pandemic.

California had a pregnancy-related mortality rate of 18.6 deaths per 100,000 live births in 2020, the state’s pregnancy-related mortality dashboard reported, compared to 12.8 the previous year.

In 2021, there were 21.6 pregnancy-related deaths per 100,000 live births in California, according to state data.

This was still lower than the United States’ pregnancy-related mortality rate during that time: 24.9 deaths per 100,000 live births.

What is a pregnancy-related death?

The Centers for Disease Control and Prevention defines pregnancy-related deaths as deaths during or within one year of the end of pregnancy from any cause related to or aggravated by the pregnancy.

The pregnancy-related mortality rate is the number of pregnancy-related deaths per 100,000 live births.

Where did pregnancy-related deaths happen in California?

There were a total of 226 pregnancy-related deaths in California from 2019 to 2021, according to the state dashboard.

Of those, 32 occurred in the northeastern and northern Central Valley, while 40 happened in the southern Central Valley, state data show.

There were 38 pregnancy-related deaths in the North and Mid-Coastal regions during that time period, and another 60 in the area that includes Santa Barbara, Ventura and Los Angeles.

A total of 26 pregnancy-related deaths were reported in the Orange, Imperial and San Diego and 30 in the Southern Inland region.

How many were caused by COVID?

According to the state dashboard, 23.5% of pregnancy-related deaths in California from 2019 to 2021 were caused by the novel coronavirus.

In comparison, 18.6% of pregnancy-related deaths during that time period were the result of cardiovascular disease, and 16.4% were caused by hemorrhages, state data show.

Other causes included pulmonary embolisms (9.3% of pregnancy-related deaths), amniotic fluid embolisms (7.1%) and hypertensive disorders (4.9%).

The U.S. Government Accountability Office published a report in October 2022 that found COVID-19 contributed to 25% of maternal deaths in the country in 2020 and 2021.

How much did maternal deaths increase in the US?

According to the CDC, a total of 1,205 women died of maternal causes in the United States in 2021.

That’s a 40% increase from the previous year, when 861 maternal deaths occurred.

In 2021, the national maternal mortality rate was 32.9 deaths per 100,000 live births, the agency said, compared with a rate of 23.8 in 2020.

Maternal deaths are those that take place during pregnancy or within 42 days following delivery, according to the World Health Organization.

A 2024 study published in the American Journal of Obstetrics and Gynecology suggests there was a much lower national maternal mortality rate – 10.4 deaths per 100,000 live births — from 2018 to 2021.

However, a CDC spokesperson told NPR that the methods used by researchers led to a “substantial undercount of maternal mortality.”

The discrepancy could also stem from a change to the national death certificate.

In 2003, the certificate was updated to include a pregnancy checkbox that the person certifying someone’s death could tick.

CDC analysts published a report in 2020 acknowledging that including the checkbox may have led to the misclassification of some deaths as maternal deaths.

This story was originally published August 12, 2024 at 6:00 AM with the headline "Pregnancy-related deaths increased nearly 70% in California. What caused the spike?."