Maternal mortality rose during the first two years of the COVID-19 pandemic, with the virus contributing to a quarter of all maternal deaths in 2020 and 2021.

According to a report from the Government Accountability Office (GAO), COVID-19 caused most of the increases in maternal deaths in the last two years, causing 25 percent of them.

The average number of monthly maternal deaths ranged from the mid-50s to the mid-60s in the two years before the pandemic began. Data from the Centers for Disease Control and Prevention (CDC) found that from January 2020 to December 2021 this monthly average rose to 85, peaking towards the end of the summer in 2021.

The rise in maternal deaths affected Black and Hispanic mothers more during this period than White women. The maternal death rate for Black women rose from 44 per 100,000 live births in 2019 to about 69 in 2021. In comparison, the maternal death rate for White women increased from about 18 to 26 deaths per 100,000 live births from 2019 to 2021.

For Hispanic women, the maternal death rate had been lower than that for White women before the pandemic — 12.6 per 100,000 live births — but grew to 27.5 in 2021, exceeding the rate of maternal deaths for non-Hispanic White women.

These disparities are not entirely surprising. Differences in the maternal health outcomes across different races have long been observed in the U.S. According to the CDC, Black women in the U.S. are three times more likely to die from childbirth than White women. This is due to factors including access to healthcare, chronic health conditions and structural racism in the American healthcare system.

Preterm births and low birthweights also grew in prevalence in 2020 and 2021 after having remained unchanged from 2016 to 2020. Though the data was limited — with only 14 states and Washington, D.C., reporting — the CDC noted that preterm and low birthweights were significantly higher for women who contracted the coronavirus while pregnant.

The U.S. has a long history of having one the highest maternal mortality rates among wealthy nations. As the U.S. is the only country among the world’s richest to not have universal healthcare, its elevated maternal mortality rate can be attributed to lack of access to health services, chronic illnesses and missed opportunities for care.