Last month, the Centers for Disease Control and Prevention (CDC) released new data indicating that national maternal mortality rates (MMR) fell significantly in 2022. Compared to 2021, the number of maternal deaths fell from 1,205 to 817 overall and the rate fell from 32.9 to 22.3 deaths per 100,000 live births. These new data suggest that maternal deaths are returning to pre-pandemic levels after spiking in 2021.

Unfortunately, what hasn’t changed is the disparities in MMR between racial and ethnic groups. While the maternal mortality rate among Black women fell by 30% (from 69.9 in 2021 to 49.5 in 2022), Black women are still more than three times as likely to die from pregnancy or childbirth complications than women overall. The maternal mortality rate also fell for White (from 26.6 to 19.0) and Hispanic (from 28.0 to 16.9) women, but did not change significantly for Asian women (16.8 in 2021 and 13.2 in 2022).

Maternal mortality rates also decreased across every age group. The greatest decrease occurred for women over age 40 (from 138.5 to 87.1), although the MMR for this group is still six times higher than for women under 25 (14.4 in 2022).

​​About a third of pregnancy-related deaths occur during the postpartum period. The Medicaid 12-month postpartum option, which allows states to extend Medicaid coverage for pregnant women through 12 months postpartum, is important because Medicaid finances over 40% of births, including a disproportionate share of Black, American Indian/Alaska Native, and Hispanic women.

States have a number of tools available to help combat maternal mortality and morbidity before, during and after pregnancy. States that have not yet adopted the Affordable Care Act’s (ACA) Medicaid expansion face bigger barriers to addressing maternal mortality, as many uninsured women fall into the coverage gap and lose out on preventive care before pregnancy. This means when women in non-expansion states become pregnant, they may become newly eligible for Medicaid under the pregnancy eligibility pathway, available at higher income levels than parents or other adults. Gaining coverage at pregnancy means many pregnant people bring preventable, untreated conditions to their pregnancy care. In addition, all but two states have or will soon implement the option to extend Medicaid coverage for postpartum women to 12 months , compared with the 60 days allowed before this option existed. Limiting postpartum coverage to less than 12 months is a missed opportunity to address root causes of pregnancy-related deaths during a time-sensitive family transition.

But the work doesn’t stop at coverage itself: states also have a responsibility to ensure benefits available to pregnant women are working as intended. Forty-three states are actively reimbursing, implementing, or proposing action to cover doula care in Medicaid. Coverage itself and community-based supports are important steps but aren’t enough to tackle the maternal health crisis alone. Success will require sustained policymaker attention at all levels, such as the recent recommendations by the Task Force on Maternal Mental Health. Hopefully the work to eliminate disparities in maternal health outcomes is only just beginning.

Editor’s note: To maintain accuracy, Georgetown CCF uses the term “women” when referencing statute, regulations, research, or other data sources that use the term “women” to define or count people who are pregnant or give birth. Where possible, we use more inclusive terms in recognition that not all individuals who become pregnant and give birth identify as women.