CLAY COUNTY — Bearing a child is the ultimate example of what it means to be a mother. 

But what about the dangers that come with it?

Maternal mortality rates in the United States have increased, leaving a lasting impact on the lives of many. 

The Center for Disease Control and Prevention (CDC) said in a 2024 report there was a maternal mortality rate of 19, or 688 deaths, in the U.S. last year, an increase from a 18.6 rate in 2023. 

It’s a multifaceted issue, according to Certified Nurse Midwife Jamie Neal. 

“There’s problems on so many levels that it makes it very difficult for us to tackle,” she said. 

What is maternal mortality? 

According to the CDC, maternal death is defined as "the death of a woman while pregnant or within 42 days after the end of a pregnancy."

The National Library of Medicine said 40% to 45% of maternal deaths happen between the start of labor and the 24-hour period immediately after birth.

There are many reasons a woman can suffer from loss of life during pregnancy or after pregnancy, some of the top being cardiac and coronary conditions, hemorrhage, infections and cardiomyopathy, or heart disease.

Over 80% of pregnancy-related deaths are preventable, according to the CDC.

Who does it affect?

Maternal mortality can impact all women, though there are some groups that are more susceptible, including those with low socioeconomic status and older females.

Maternal mortality also disproportionately affects ethnic minority women, particularly Black women. 

According to the CDC, in 2021, Black women had a mortality rate of 69.9 deaths per 100,000 live births — 2.6 times higher than White women. 

Why does it happen?

Neal said there are many reasons as to the large number of pregnancy-related deaths that occur yearly.  The main one being access to proper healthcare.

She said that a lot of pregnant women who don’t have insurance have to apply for Medicaid, a public health insurance program that provides healthcare coverage to low-income families and individuals.

The American Hospital Association said Medicaid covers over 40% of births in the U.S., including almost 50% in rural communities. 

But, she said there are a lot of providers who don’t accept this form of coverage. Mainly due to bureaucratic burdens, low reimbursement and administrative costs. This makes it difficult for patients to get access to quality care. 

Neal said it is also common for practices to only accept patients at certain gestational stages in their pregnancy, neglecting patients who may be too far along by the time they are able to see a provider.

On the flip side, she added that women may have underlying medical conditions that could exacerbate after getting pregnant. This can also be difficult for providers. 

“They realize now we’re not just dealing with a pregnant woman, but we’re dealing with a pregnant woman with blood pressure problems or a pregnant woman with diabetes or even asthma, or anemia,” she said.

For those who may also speak another language, these barriers can also play a role in getting adequate care. 

Additionally, older women, specifically ages 40 and up, can have a higher chance of mortality due to increased health risks, according to Yale Medicine. 

The overall fear of healthcare is another reason.

“A lot of women will just shut down and not say something’s wrong when something's wrong. That hinders their healthcare process, and it hinders us in being able to take care of them,” she said

For women of color, Neal said the bias within the the health care system is often the reason. As previously mentioned, Black women have the highest mortality rate due to many factors, including systemic racism and underlying health conditions. 

“Women of color, Black women and other women too tend to not be heard sometimes,” she said. “People think that they're exaggerating their symptoms or they just reason their symptoms away until it becomes a severe problem.” 

Neal said that because of this, there is sometimes a distrust that exists.

How can it be fixed?

Neal said that awareness is the first step.

“What was super surprising to me was some of the people that I worked with in healthcare who were unaware of the problem,” she said. 

Although there is a long way to go, she said it brings hope knowing that more people are becoming mindful. 

“Everyone has bias, but we just need to make people aware of their biases and help them with a healthy way to deal with those. And especially dealing with other people who need their compassion and their help.”

As the co-founding owner of Life Tree Women Care on Blanding Boulevard, Neal said she sees these circumstances firsthand frequently. With patients in and out the door daily, she said her practice aims to provide an environment where women are heard and seen. 

“I encourage them to speak up and be clear about their symptoms,” she said. “If they have a concern or problem, I try to encourage them.” 

She also said keeping the lines of communication open is key, whether that’s educating families on why she’s doing certain tests or running certain scans, or reassuring them that everyone in the office is a team and there to help. 

“It’s really difficult to address this problem and it's going to take many years, I think, for things to drastically change," Neal said. "But we have to take it one person at a time and one woman at a time.”