US maternal mortality spike unrelated to Covid shots

Anti-vaccine advocates are linking a recent spike in the US maternal mortality rate to Covid-19 shots. This is false; public health authorities around the world recommend the jabs for preventing severe illness and death in those who are pregnant, and experts say rising maternal deaths are due to factors such as health care access gaps, chronic conditions and the coronavirus itself.

"DISTURBING: 'Pregnant American Mothers are Now Dying at Alarming Rates,'" says a March 19, 2024 post on X from an account called "The Vigilant Fox," which AFP has fact-checked for spreading misinformation in the past.

"Why? Don't look at the COVID-19 injections."

The post includes a video of US cardiologist Peter McCullough talking about a March 2023 report from the Centers for Disease Control and Prevention (CDC), which found the number of Americans who died of maternal causes increased by about 40 percent between 2020 and 2021 (archived here).

"Pregnant women are dying with the baby in the womb," says McCullough, who has previously promoted falsehoods about vaccination, in the video shared online.

"And in that manuscript, there's no mention of Covid, and there's no mention of the vaccines. They're simply reporting this bad news that pregnant American mothers are now dying at alarming rates."


Screenshot from X taken March 21, 2024 

Similar claims have circulated elsewhere on X, as well as Facebook, Instagram and TikTok -- including in Canada.

The narrative is the latest in a wave of misinformation about Covid-19 vaccines, which researchers estimate have saved millions of lives. AFP has repeatedly debunked claims that the shots are harmful to pregnant people and infants.

US maternal mortality surged in the second year of the Covid-19 pandemic -- with Black people more than twice as likely to die than white people, according to the 2023 report from the CDC's National Center for Health Statistics (NCHS). The rate was the highest among high-income nations, and the number of deaths in 2021 was the most since the mid-1960s.

But Sadiya Khan, a cardiologist at Northwestern Medicine (archived here), told AFP the increase began "before vaccinations and continued after vaccinations were available."

"And there is absolutely no evidence that suggests Covid-19 vaccines led to the spike," she said in a March 21, 2024 email. "In fact, Covid-19 vaccines are protective and recommended for pregnant people."

Nick Spinelli, a spokesperson for the CDC, told AFP in a March 22 email: "Covid-19 vaccination during pregnancy is safe."

What is driving mortality rates?

Experts pin rising maternal deaths in the United States on a combination of health care access problems, an aging population, chronic conditions and the pandemic.

According to an October 2022 report from the US Government Accountability Office (archived here), a quarter of maternal deaths in 2020 and 2021 combined were associated with Covid-19. A meta-analysis published in January 2023 found pregnant people with the virus were seven times more likely to die than their uninfected peers (archived here).

"The Covid-19 pandemic had a dramatic and tragic effect on maternal death rates," said Iffath Abbasi, then-president of the American College of Obstetricians and Gynecologists (ACOG), in a March 2023 statement (archived here).

"But we cannot let that fact obscure that there was -- and still is -- already a maternal mortality crisis to compound."

Data from the World Health Organization (WHO) show the US maternal mortality rate has steadily risen since the 1990s (archived here). A March 2024 study co-authored by Khan of Northwestern Medicine found the rate nearly doubled between 2014 and 2021, with the largest increase occurring between 2019 and 2021 (archived here). 


Graphic showing the maternal mortality ratio (number of maternal deaths per 100,000 live births) between 2000 and 2020 for the 10 countries with the highest increases, according to World Health Organization data (AFP / Jonathan WALTER, Sophie RAMIS) 

The American Medical Association has identified several contributing factors, including: "poor insurance coverage prior to, during and after pregnancy; lack of interprofessional teams trained in best practices; and closure of maternity units in many rural and urban communities" (archived here).

The professional association notes maternal death disproportionately affects Black people in part due to "health care access problems, underlying chronic conditions, and structural racism and implicit bias."

Age also plays a role.

US census data show the median age of people giving birth rose from 27 in 1990 to 30 in 2019 (archived here). The NCHS said in its 2023 report that mortality rates in 2021 "increased with maternal age."

"Health risks increase as we age, and, thus, older women are more likely to have health conditions when they get pregnant," Monique Rainford, a Yale Medicine obstetrician-gynecologist (archived here), said in a May 22, 2023 blog post (archived here).

However, that is not the whole story. The Northwestern study found maternal mortality rose for every age group, with the greatest relative increases among people aged 25 to 34.

"Older maternal age is an important risk factor in maternal mortality, but our findings highlight the need to learn what else is causing these rates to accelerate in more recent years, especially in younger adults less than 35 years old," Khan said in a March 18, 2024 press release (archived here).

Khan's research has identified cardiovascular disease as a primary contributor to maternal mortality (archived here).

'No evidence' of adverse effects

The CDCWHOACOG and Society for Maternal-Fetal Medicine all recommend pregnant people get vaccinated against Covid-19 (archived here, here, here and here).

"Given the potential for severe illness and death during pregnancy, the importance of completion of the initial Covid-19 vaccination series should be emphasized for this population," ACOG says on its website.

Citing several different safety studies (archived here, here and here), the professional association adds that there is "no evidence of adverse maternal or fetal effects from vaccinating pregnant individuals with Covid-19 vaccine."

The CDC is monitoring some adverse events reported after Covid-19 vaccination, but says on its website people who receive the shots "are at no greater risk of death from non-Covid causes than unvaccinated people."

AFP has fact-checked other false and misleading claims about vaccination here.

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