New data is painting a clearer picture of how the pandemic has affected pregnancies and births across the world, and revealing big disparities between lower- and higher-income countries.

A review published in the journal Lancet Global Health compiled data from 40 different studies conducted in 17 different countries between January 2020 and January 2021. Examining data from more than six million pregnancies, the review found some alarming results: stillbirths, maternal deaths, ectopic pregnancy and maternal depression and anxiety all saw big increases globally.

Stillbirths went up by 28% during that time frame, and the number of women who needed surgery for ectopic pregnancy was six times higher than normal. In Mexico and India, the chances of maternal death (either during pregnancy or childbirth) went up by about a third.

Researchers chalked up some of the increases to pregnant individuals having less access to healthcare during the pandemic. “Health-care providers around the world have reported reduced attendance for routine and unscheduled pregnancy care,” the report said, while offering several different possible explanations. “This reduction could be driven by concern about the risk of acquiring COVID-19 in health-care settings, governmental advice to stay at home, or reduced public transport and childcare access during lockdowns.”

“It is clear from our study and others that the disruption caused by the pandemic has led to the avoidable deaths of both mothers and babies, especially in low- and middle-income countries,” said Dr. Asma Khalil, a professor of obstetrics at St. George’s University of London and the lead author of the review.

Another new report shows that the maternal death rate was on the rise in the U.S. even before the pandemic. A CDC report found that maternal deaths rose by more than 15% in 2019—with the Black women experiencing the biggest increase.

The common link between these two reports is this: So many of these deaths are preventable. “There is an urgent need to prioritize safe, accessible, and equitable maternity care within the strategic response to this pandemic and in future health crises,” the Lancet review said.

Diana Spalding, CNM said that fixing this problem is absolutely the responsibility of lawmakers and health care providers. “Still,” she said, “Never be afraid to advocate for yourself. If you are concerned that you need medical care, you should get it, plain and simple. If you can’t get your provider to listen to your concerns, call the hospital’s patient advocacy department or a lawyer.”

To address the urgent need here in the U.S., lawmakers introduced a bill dubbed the “Momnibus Act” earlier this year aimed at improving maternal health outcomes, especially among people of color. As Senator Cory Booker, one of the bill’s co-sponsors said at the time, “We simply cannot continue to accept this alarming status quo.” That’s as true today as it was then, and these latest studies only offer more proof. Mothers and babies here in America and across the world need more support, care and protection—and they need it now.