In 2021 and 2022, the maternal death rate for Black women was about 2.6 times higher than white women.

The data suggest that the COVID-19 pandemic, at its peak, impacted all pregnant women. But “once we went back to ‘usual activities,’ then the impact of systemic racism and unequal access (to medical care) … came right back into place,” said Dr. Amanda Williams, interim medical director for the March of Dimes.

The Centers for Disease Control and Prevention’s report Wednesday on the 2023 deaths was drawn from death certificates. The CDC counts women who died while pregnant, during childbirth and up to 42 days after birth. Accidental deaths are excluded.

The report found:

1. The maternal death rate for white women dropped from 19 deaths per 100,000 live births in 2022 to 14.5 per 100,000 in 2023.
2. The rate for Black women went from 49.5 to a little above 50, though the report says that increase was not statistically significant.
3. The rate for Hispanic women dropped from about 17 to about 12.
4. The rate for Asian Americans fell from about 13 to about 11.

In total, 669 women died in 2023 during pregnancy or shortly after childbirth, the CDC reported. That’s down from 817 deaths in 2022 and 1,205 in 2021, when it was the highest in more than 50 years.

Excessive bleeding, blood vessel blockages and infections are leading causes of maternal deaths.

Among those infections is COVID-19. The coronavirus and its complications proved dangerous to pregnant women. And, in the worst days of the pandemic, burned out physicians may have added to the risk by ignoring pregnant women’s worries, experts say.

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COVID-19’s overall impact on pregnancies declined as the pandemic subsided and as hospitals and birthing centers returned to normal operations.

Also, the federal Medicaid program expanded to cover postpartum care for up to 12 months, instead of just seven weeks. That helped more moms recover and made them healthier for the next time they tried to have a baby, Williams said.

The number of maternal deaths is also tied to the number of pregnancies. U.S. births have been declining, and fewer pregnancies contributes to fewer pregnancy-related deaths, noted Eugene Declercq, a maternal deaths researcher at Boston University.

CDC officials refused an Associated Press request to talk to a report author.

The government is still receiving and processing death reports from last year. But Declercq said his analysis of available data suggests the number of 2024 maternal deaths may end up about the same as 2023.