The pregnancy-related death ratios provide a vital measure for examining the quality of maternal healthcare. Recently, a significant study analyzed these metrics between 2018 and 2024 to gauge the impact of the COVID-19 pandemic. The researchers found that while some indicators showed resilience, others remained surprisingly high long after the pandemic peaked. Understanding these shifts is crucial for healthcare providers in India as they work to improve maternal outcomes and health equity.
During the primary pandemic years of 2020 to 2022, maternal mortality experienced a sharp increase. Specifically, the early pregnancy-related death ratio rose by 7.5 deaths per 100,000 live births. Meanwhile, late pregnancy-related deaths, which occur 43 to 365 days after delivery, also increased. Importantly, COVID-19 infections were the main driver, accounting for 76% of the rise in early deaths. In India, disruptions to emergency services led to similar temporary setbacks in maternal health progress.
Recovery of Pregnancy-Related Death Ratios
By the 2023-2024 period, early pregnancy-related death ratios successfully returned to their prepandemic baselines. However, the data concerning late pregnancy-related deaths revealed a persistent problem. These ratios remained elevated by 1.4 deaths per 100,000 live births compared to the 2018-2019 period. This suggests that the indirect effects of the pandemic, such as chronic health issues or healthcare access gaps, might still influence outcomes. Consequently, clinicians should emphasize extended postpartum care throughout the first year after childbirth.
Persistent Disparities in Maternal Outcomes
The research clearly demonstrates that recovery was not uniform across all sociodemographic groups. For instance, both early and late death ratios remained significantly elevated among non-Hispanic Black mothers. This finding highlights deep-seated inequities that the pandemic likely worsened. Similarly, in India, marginalized communities and rural populations often experience higher maternal mortality ratios. Although the national MMR in India improved to 88 per 100,000 live births by 2023, addressing regional disparities remains a top priority for clinical and policy initiatives.
Frequently Asked Questions
Q1: What is the difference between early and late pregnancy-related deaths?
Early deaths are those occurring during pregnancy or within 42 days following its termination. In contrast, late deaths refer to maternal mortality that occurs between 43 and 365 days after delivery.
Q2: Why did late pregnancy-related deaths fail to recover as quickly?
Late deaths may remain elevated due to the long-term physiological impact of COVID-19 or socio-economic disruptions that affect access to care. This highlights the need for ongoing maternal support well beyond the immediate postpartum period.
Q3: How does India’s maternal mortality compare to these trends?
India has shown a strong downward trend, with its maternal mortality ratio dropping to 88 per 100,000 live births by 2023. However, like the disparities noted in the study, India still faces significant regional and social inequities.
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.
- Vajiram & Ravi. Maternal Mortality in India, Causes, Progress, Challenges, Solutions. March 31 2026.
- Niti Aayog. Special Bulletin on Maternal Mortality in India, 2021-23. September 2025.