The COVID-19 pandemic significantly disrupted maternal healthcare systems globally. Consequently, medical researchers have closely monitored pregnancy-related death ratios (PRDR) to understand the long-term impact on maternal survival. A comprehensive study covering 2018 to 2024 analyzed nearly 8,300 deaths to determine if maternal mortality has returned to its pre-pandemic baseline. While the initial surge was largely attributed to direct COVID-19 infections, the recovery phase reveals a complex picture of health inequity and timing-specific risks.

Data indicates that early pregnancy-related deaths—occurring during pregnancy or within 42 days postpartum—have largely stabilized at pre-pandemic levels. However, late pregnancy-related deaths, which occur between 43 and 365 days after delivery, remain notably elevated. This lingering increase suggests that postpartum care beyond the standard six-week checkup requires more clinical attention and policy support. Furthermore, the contribution of COVID-19 to these deaths was substantial, accounting for 76% of the early and 50% of the late PRDR increases during the peak pandemic years.

Disparities in Pregnancy-Related Death Ratios

One of the most concerning findings is the uneven nature of the recovery across different sociodemographic groups. Specifically, pregnancy-related death ratios among non-Hispanic Black mothers have not returned to their 2018-2019 benchmarks. Both early and late death ratios for this group remained significantly higher in 2023-2024. Moreover, geographic and age-based variations further complicate the recovery landscape, highlighting that systemic factors continue to drive maternal health outcomes.

Clinicians and healthcare administrators must prioritize extended postpartum monitoring to address these gaps. Focusing on late-onset complications and social determinants of health is essential for reducing preventable deaths. Additionally, integrating respiratory infection management into obstetric protocols could help mitigate future risks. Promoting health equity requires targeted interventions that address the specific needs of vulnerable populations who have not yet seen a full recovery in their maternal health metrics.

Frequently Asked Questions

What is the difference between early and late pregnancy-related deaths?

Early pregnancy-related deaths occur during pregnancy or within 42 days of its conclusion. Late pregnancy-related deaths happen between 43 and 365 days postpartum. Recent trends show that late deaths are recovering more slowly than early ones.

Why did pregnancy-related death ratios remain high for some groups after the pandemic?

Recovery depends on various factors, including access to healthcare, economic stability, and systemic disparities. Groups like non-Hispanic Black mothers continue to experience elevated ratios, possibly due to persistent gaps in late postpartum care and social inequities.

Disclaimer: This content is for informational and educational purposes only and does not constitute medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.

References

MacCallum-Bridges CL et al. Recovery of Pregnancy-Related Death Ratios After the Coronavirus Disease 2019 (COVID-19) Pandemic: Disparities by Age, Race and Ethnicity, and Geography. Obstet Gynecol. 2026 Apr 02. doi: 10.1097/AOG.0000000000006255. PMID: 41926774.

Columbia University Mailman School of Public Health. COVID Doubled U.S. Maternal Deaths; Reporting Changes Complicated Pre-Pandemic Data. April 2025.

UNFPA. Trends in Maternal Mortality 2000-2023: Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. 2023.