What You Should Know About America’s High Rate Of Maternal Mortality

Image courtesy of claudiaheidelberger

When you think about fatalities during childbirth, your mind may immediately leap to infant deaths. But although it’s much safer to give birth in America now than say, 100 years ago, women are dying from pregnancy or childbirth-related causes at a higher rate than any other country in the developed world.

An in-depth investigation into maternal mortality by NPR and ProPublica highlights the tragic story of a neonatal nurse who died less than a day after giving birth in the hospital where she works. It’s a tale more common in this country than you might think, even with medical innovations and improved living standards in the modern era.

While we highly recommend reading NPR and ProPublica’s investigative report in its entirety, here are just a few of the things we learned about maternal mortality in the U.S.:

700 to 900 women die from pregnancy or childbirth-related causes every year in the U.S.: And about 65,000 women nearly die, the investigation found, resulting in the worst rate of maternal deaths in the developed world. Of those, 60% are preventable, according to an analysis by the CDC Foundation.

Maternal deaths are on the rise in America: While maternal deaths increased from 2000 to 2014 in the U.S., rates went down in every other wealthy country — and many less affluent ones, the report found.

In the United Kingdom, for example, journal Lancet noted that the rate has gone down so dramatically that “a man is more likely to die while his partner is pregnant than she is.”

Pregnancy and childbirth complications kill women from all walks of life: Though maternal mortality is significantly more common among African Americans, low-income women, and those in rural areas, NPR and ProPublica found that women of all races, ethnicities, income levels, and education are dying from such complications.

And they’re dying from a variety of causes — including cardiomyopathy and other heart problems, massive hemorrhage, blood clots, infections, and pregnancy-induced hypertension (preeclampsia) — days or even weeks after leaving the hospital.

There’s no one factor contributing to high maternal mortality in America: Women are giving birth later than life nowadays, which means they could have more complex medical histories. Unplanned pregnancies account for half of all pregnancies in the country, and not all of those woman have addressed chronic health issues beforehand.

The health care system doesn’t make it easy on new mothers to get the care they need, either, especially those who don’t have good insurance.

Meanwhile, infant mortality is at its lowest point in history: Although the number of babies who die annually in the U.S. still exceeds the number of expectant and new mothers who die from complications related to childbirth, the gap is narrowing. This could partly be because we all just assume that modern medicine has defeated maternal mortality.

“We worry a lot about vulnerable little babies,” Barbara Levy, vice president for health policy/advocacy at the American Congress of Obstetricians and Gynecologists (ACOG) and a member of the Council on Patient Safety in Women’s Health Care, told NPR and ProPublica, while “we don’t pay enough attention to those things that can be catastrophic for women.”

Reformers are mobilizing: Although other governments have made a concerted effort to combat maternal mortality — including the UK, where a national committee of experts analyzes every death of a woman from pregnancy or childbirth complications — we don’t have a comparable effort here, NPR and ProPublica note. Instead, those types of reviews are left up to states, which often have tight resources for such measures.

But there are advocates here who are making strides modeled on the UK’s process, including the work of the California Maternal Quality Care Collaborative, which is trying to reduce mortality as well as life-threatening complications and racial disparities in obstetric care.

Among other efforts, the group has created a series of “toolkits” designed to help doctors and nurses improve how they handle emergencies like obstetric bleeding and preeclampsia. CMQCC’s work has also inspired advocates in other states to create their own initiatives.

Still, there’s a long way to go: Medical protocol isn’t adopted in a day, or even a year. The Institute of Medicine says it takes 17 years for such changes to take place on a widespread basis.

Obstacles include a lack of money, training, and in the case of some smaller providers, hospitals that don’t see the point of changing anything.

“It’s very hard to get a hospital to provide resources to change something that they don’t see as a problem,” ACOG’s Levy said. “If they haven’t had a maternal death because they only deliver 500 babies a year, how many years is it going to be before they see a severe problem? It may be 10 years.”

Again, it’s definitely worth giving the entire report a thorough read.