I'm gonna risk sounding dismissive here but the article very cautiously points at a cause: "While this study wasn’t able to explore specific causes of death, a large body of prior research, much of it published by Khan, has found cardiovascular disease (hypertensive disorders, heart failure and stroke) is a major contributor to poor maternal health outcomes."
Hypertensive disorders are typically associated with obesity so the reason could be that there's an increasing share of pregnancies happening with people who are overweight. I leave the sociodynamic interpretation of this up to the reader.
Obesity rates increased slightly between 2014 to 2021, but I’m not sure that will account for doubling of mortality rate. It could mean that more obese people are having kids than before, but that would be far from trivial to prove
I'd first look at the use of assidted fertility treatments (ARTs). I can't find solid data on trends that cover through 2021, but infertility rates and the use of ARTs have both gone up.
It seems reasonable that there would be increased risks during a pregnancy when the body wasn't prepared to get pregnant without intervention.
Unplanned pregnancies might happen to people who aren't ready to have a child, physically and mentally - or who don't have easy access to medical care.
IVF, in contrast, only produces planned pregnancies, and only in people with easy access to medical care.
This would be my assumption, though I haven't found data on it and frankly it is a pretty politically unpopular topic to research.
The human body wants to reproduce as its default state. When it can't, there must be physical or environmental reasons (or the likely rare genetic condition that can be a primary cause of infertility).
For sure. The human body after decades of low level environmental toxins can also struggle.
I raise this only as personal guess and don't have data to support it, but I very much expect that issues often seen today with what are referred to as "geriatric pregnancies" are related more to the consistent drip of toxins in our water, air, and foods rather than an issue driven only by aging.
Would it require matrix-level test tube humans to decouple the effects of age from the world environment everyone share? Humans will probably always deal with air issues from lightning induced fires though.
I guess if we look at maternal deaths versus time for healthy BMI folks from the ages of 20-21 over the last century we could gather some insight.
Well that's really why there isn't solid data for it, how do you have a control group when the problem is universal?
Historical data may help a bit, though I expect it'd still be really hard to narrow down enough factors to get anything meaningful out of it. There are so many environmental changes from our food, what's in our water, pladtic and chemical uses in everyday products, radio frequencies we're exposed to, etc.
These days most unplanned pregnancies would probably fall on physical prime as opposed to planned ones. And mental state doesn't really have effect on maternal death rates.
I agree with GP that IVF probably provides motherhood to a lot of people who have preexisting medical issues.
chronic COVID-19 infection may have more adverse effects on the menstrual cycle than COVID-19 vaccines, which have so far presented no long-term adverse events linked to fertility or reproduction
So there’s nothing detrimental, just a temporary change (which can happen for many reasons).
Because respiratory virus is an oversimplification of COVID, yes that's why people die from it, but it affects all cells with ACE2 receptors, for example neurons and blood vessel linings.
Covid virus during pregnancy increases risk of bad outcomes dramatically, but a lot of patients have the wrong (reverse) idea, and therefore refuse the vaccine. Refusing the vaccine is probably a contributing factor. (Source: wife is OB).
Hypertensive disorders are typically associated with obesity so the reason could be that there's an increasing share of pregnancies happening with people who are overweight. I leave the sociodynamic interpretation of this up to the reader.