Maternal mortality in the pandemic has reached frightening numbers

A recently published Brazilian study brought alarming data about the impact of the Covid-19 pandemic on maternal health. In 2020, there was an excess of maternal deaths of approximately 40% compared to the average of previous years. In 2021, there was an explosion in the number of cases, and covid-19 was responsible for 60% of maternal deaths that year.

According to the study authors, these data suggest that the pandemic penalized pregnant and postpartum women more than the general population. The maternal mortality rate in 2021 drastically exceeded the global target of the Sustainable Development Goals for this indicator (70 maternal deaths per 100,000 live births), reaching a level of approximately 110 maternal deaths per 100,000 live births – a level similar to that presented by Brazil in the 1980s.

Another Brazilian survey showed that the North and Northeast regions were the most impacted by excess maternal mortality in 2020, while in 2021 the impact was greater in the Central-West and South. The worst scenario occurred between March and June 2021 throughout the country. country, reaching an excess of 413% in the mortality of mothers between 35 and 49 years old in the South region.

Brazilian numbers are frightening when compared to those of other developing countries. In Chile, for example, maternal mortality increased from 19.2 to 28.1 per 100,000 live births. In Central Asian countries, in turn, maternal mortality ranged from 18.5 to 36.5 for every 100,000 live births during the pandemic, numbers also higher than in previous years. Colombia, which before the pandemic already had a high maternal mortality rate of 80 per 100,000 live births, saw an increase to 87 per 100,000 live births.

The data from the United States is also worrying. The maternal mortality rate, which was 20.1 per 100,000 live births in 2019, rose to 23.8 in 2020 and to 32.9 in 2021. The racial issue is important here: in the black population, maternal mortality reached 69.9 per 100,000 live births, more than two and a half times the rate in the white population (26.6 per 100,000 live births).

Furthermore, an American study carried out in the first year of the pandemic showed that maternal mortality in the presence of a confirmed Covid-19 infection ranged from 232.9 to 79.1 per 100,000 births between April and December 2020. These numbers are more than ten times higher in relation to maternal mortality not related to Covid-19.

Maternal mortality is influenced by the quality of care, which involves issues such as access and availability of resources; prenatal, childbirth and postpartum practices; as well as social, economic and ethnic disparities in women’s health as a whole.

It is not possible to explain the alarming Brazilian numbers, when compared to those of other countries, just for biological reasons. During the pandemic, Brazil experienced a huge overload on its health system, with difficulty in promoting prenatal care for pregnant women, with barriers to accessing birth care, in addition to low availability of intensive care beds. The occurrence of a critical period in 2021 also suggests the slow adoption of measures to control and mitigate the effects of the pandemic, such as vaccinating pregnant and postpartum women.

In 2022, maternal mortality fell to 57.7 maternal deaths per 100,000 live births. Statistics for the year 2023 are not yet consolidated. However, we still have a long way to go to reach Brazil’s Sustainable Development Goals target of less than 30 maternal deaths for every 100,000 live births.

It is important to remember that many of these women who died in the pandemic left behind families and children. A 2022 Brazilian study showed that, in the first two years of the pandemic, more than 40 thousand children were left motherless. This impacts the well-being and structure of families, and increases children’s vulnerability to emotional and behavioral problems, even in the long term.

Finally, it is still possible that Brazil will see changes in its population pattern over the next few years as a result of the pandemic. There is an expectation, for example, that the process of population reduction will accelerate. It may be too early to say that excess maternal deaths will have an impact on a population level, but it is certainly something to keep an eye on.