Assessing Racial and Ethnic Disparities in Timing of Pregnancy Related Deaths

Existing research documents significant racial disparities in pregnancy-related deaths in the United States. Recently, the National Center for Health Statistics (NCHS) identified inconsistencies in maternal mortality data due to irregularities in previous data collection. Yet, corrections of the data still highlight stark differences across racial identity. Additionally, data indicates that while many people die during labor and delivery, a considerable percentage of people die up to a year postpartum. To assess disparities in the timing of pregnancy-related deaths using corrected data, we analyzed aggregated vital statistics data from 2015 to 2018 (n = 4,261). We present relative risk ratios from multinomial logistic regressions to examine the association between race and ethnicity and the timing of pregnancy-related deaths (pregnant at the time of death, 42 days post pregnancy, and 43 days to one-year post pregnancy). Results highlight significant differences in the distribution of timing of pregnancy-related deaths across nativity status and geographic region. Findings document a disproportionate percentage of pregnancy-related deaths among foreign-born people who give birth. Overall, results suggest extending our framing of postpartum care beyond a hospital stay. What is already known on this subject?Data shows that there are significant socioeconomic and racial disparities in pregnancy-related deaths, with Native American and Black women having elevated risk of mortality (Leonard et al., Health Services Research 48(2):455-475, 2019). Reduced access to affordable and adequate maternal care through closures of medical clinics, provider bias, and the rising cost of healthcare have been shown to significantly contribute to higher rates of pregnancy-related deaths, particularly among low-income and racial minority women (Lorch et al., Health Services Research 48(2):455-475, 2013).What does this study add?This study provides assessments of racial disparities in timing of pregnancy-related deaths that emphasize important differences across nativity status to help us understand these disparities.