Health News

Tennessee Maternal Deaths Decline in 2022 After COVID Highs, but Disparities Remain

Tennessee saw a 26% drop in pregnancy-associated deaths in 2022 after a significant spike during the COVID-19 pandemic, according to a report from the state’s Health Department. While this decline is promising, stark disparities based on race, income, and geography continue to mar the picture, signaling that much work remains to be done to protect the health of all pregnant women.

Persistent Disparities in Maternal Deaths

Despite the overall decline in maternal deaths, certain groups in Tennessee continue to face higher risks during pregnancy and the postpartum period. Black women, unmarried women, low-income women, and those with less education are among those who suffer the highest mortality rates. Women living in urban areas have also experienced disproportionately high rates of pregnancy-associated deaths.

The report highlights that pregnancy-related mortality rates are significantly worse for women relying on TennCare, the state’s Medicaid program for low-income residents. The statistics show that maternal deaths among those with TennCare coverage were nearly three times higher than those with private health insurance.

In addition to these racial and economic disparities, geographic location also plays a critical role. The eastern third of the state, particularly the 33 counties in East Tennessee, experienced a troubling increase in pregnancy-related deaths in 2022. This region saw a dramatic fourfold rise in pregnancy-associated deaths over the course of three years (2020-2022) when compared to the prior period of 2017-2019. State officials attribute much of this spike to substance use disorder, which has worsened in the region during the pandemic.

The Impact of COVID-19 and Tennessee’s Abortion Ban

The period from 2021 to 2022 was marked by a range of disruptions, including the ongoing effects of the COVID-19 pandemic and the implementation of Tennessee’s near-total abortion ban in August 2022. The report notes that 76% of the pregnancy-related deaths in 2022 were preventable, underscoring that more effective interventions and care could save lives.

Tennessee pregnancy-related deaths

While the numbers show a decrease in maternal deaths from 134 in 2021 to 100 in 2022, they also reflect the added complexities of navigating health care systems during a pandemic and under new, restrictive abortion laws. The 2022 decline in deaths is certainly a positive step, but it is crucial to remember that these numbers don’t provide a clear view of long-term trends due to the unique circumstances of the COVID-19 era.

Tennessee’s strict abortion law, which came into effect in August 2022, allows exceptions only for cases where the health risks to the pregnant person are severe, but reproductive health advocates have raised concerns about the vagueness of these exceptions. Many doctors have expressed concerns that the law’s language could prevent them from offering potentially life-saving care, adding a layer of uncertainty and fear for pregnant patients.

Addressing the Root Causes: Substance Use, Access to Care, and Health Insurance

The rise in maternal deaths, especially in the eastern part of Tennessee, calls attention to the growing substance use disorder crisis in the region. Health experts point to a lack of access to proper treatment and resources as major contributors to the increase in pregnancy-associated deaths. East Tennessee, with its higher rates of substance use, is a stark example of how broader public health issues can intersect with maternal health outcomes.

Additionally, the report underscores the importance of access to quality health care for pregnant women. The disparities between those with TennCare and those with private insurance reveal how different levels of coverage directly affect maternal outcomes. Pregnant women covered by TennCare experience higher maternal mortality rates, a troubling finding that highlights the need for expanded and more comprehensive healthcare access, particularly for low-income individuals.

Addressing these issues requires not only better healthcare access but also policies that tackle systemic inequality across race, geography, and economics. As the state’s health department and lawmakers continue to examine maternal deaths in Tennessee, it will be crucial to take these disparities into account when proposing new initiatives aimed at protecting mothers.

Looking Ahead: What Needs to Change?

In the coming years, Tennessee must address the key factors that contribute to the high rates of preventable pregnancy-related deaths. This includes:

  • Expanding access to healthcare, especially for low-income women and those on TennCare.
  • Providing more comprehensive maternal health services that address issues like substance use disorder in areas like East Tennessee.
  • Reevaluating the effects of Tennessee’s abortion ban, particularly in light of concerns from doctors and reproductive rights groups about the law’s impact on life-saving care.

Ultimately, the 26% decline in pregnancy-associated deaths in 2022 is an encouraging sign, but the persistent disparities point to a pressing need for continued reform in Tennessee’s healthcare system. The question remains: can the state overcome these longstanding inequalities and ensure that all pregnant women have access to the care they need?

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