Report: Pregnancy-related deaths in Tennessee spiked during height of COVID-19 pandemic

A new state report confirms what state and federal health officials have suspected for months — namely, that maternal deaths spiked in Tennessee as the COVID-19 pandemic raged on in 2021, fueled in large part by drug use, mental health disorders and racial discrimination.

During this period, Black women were more than twice as likely to die as non-Hispanic white women.

And nearly half of the women who died from pregnancy-related causes within a year of giving birth died from complications related to COVID-19, according to the report. Most were unvaccinated. Mental health disorders and substance use were a factor in roughly a third of these deaths.

The study notes that most such cases were likely preventable.

"It remains heartbreaking that Tennessee has such high maternal mortality and morbidity rates and that so many of the deaths are deemed preventable," said Dr. Nikki Zite, a professor and vice chair of education and advocacy in the Department of OB/GYN at the University of Tennessee Graduate School of Medicine. "The lack of access to equitable healthcare related to not expanding Medicaid and hospital closures compounded by vaccine hesitancy and criminalizing both abortion care and substance use disorder is setting Tennessee up for continued poor trends."

Tennessee's pregnancy-related death rate in 2021 (64.9 deaths per 100,000 live births) was nearly twice the prior four-year average rate of 35.4 deaths per 100,000 live births, the report notes. A separate analysis by the non-profit health policy organization KFF ranks the state as the third-worst in the nation for such mortality rates.

Report: Domestic violence against women a 'leading cause' of associated deaths

Deaths following pregnancies are classified as either "pregnancy-related" or "pregnancy-associated." Pregnancy-related means the pregnancies themselves were aggravating factors in the deaths. Pregnancy-associated means the woman died within a year of giving birth.

Another 63 women died in 2021 from "pregnancy-associated" causes. Most were younger than 30 and, in most cases, substance use disorders — often leading to overdose deaths — were contributing factors in their deaths, according to the report.

Domestic violence against these women was also a "leading cause" of these associated deaths, though the report did not provide statistics.

Related coverage: Tennessee ranks 49th among U.S. states in helping struggling families and children, Vanderbilt report shows

More: As Tennessee sees lack of maternal care, it's increasingly 'dangerous to be pregnant' in rural areas

The report includes general recommendations on improving outcomes, but stops short of specifics on how to achieve these goals.

Dr. Tobi Amosun is "committed to lowering Tennessee’s maternal mortality deaths'

Recommendations include making sure pregnant women are vaccinated, improving access to mental health care, improving health centers' ability to treat obstetric hemorrhage and post-partum complications, improving access to prenatal care, making sure households have access to naloxone (used to reverse opioid overdoses) and better screen women for signs of domestic abuse.

"We are committed to lowering Tennessee’s maternal mortality deaths," said Dr. Tobi Amosun, deputy commissioner for population health for the state's Department of Health, in a written statement. "Our plan is to work with statewide agencies, hospital systems, medical clinics, healthcare providers, and community members on pursuance of the recommendations in the report.”

Health Department officials offered no predictions about whether death rates dropped markedly statewide in 2022 after the worst of the pandemic had subsided. A report on that 12-month period won't come out until next year.

Frank Gluck is the health care reporter for The Tennessean. He can be reached at fgluck@tennessean.com. Follow him on Twitter at @FrankGluck.

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This article originally appeared on Nashville Tennessean: New report: pregnancy-related deaths continue to spike in Tennessee