The United States has one of the best medical systems in the world, but you wouldn’t know it from the number of moms who die during or within a year of child birth.
On average, two moms a day will die. They will hemorrhage. High blood pressure will lead to organ failure and seizures. Or they will develop infections their bodies can’t fight off. If you are black the chances are three to four times higher.
Embarrassing. Shocking. Tragic. That is how panelists at a recent conference sponsored by the Johns Hopkins Bloomberg of School of Public Health described the country’s problem with maternal health. Others have called it a moral failure.
They’re right; there is no reason for many of these moms to die.
The U.S. has the highest rate of maternal mortality among developed countries, at a rate of 26.4 deaths per 100,000 births, and is the only industrialized nation with a rising maternal mortality rate. There was a 26 percent increase in the maternal mortality rate between 2000 and 2014. Nearly 60 percent of these deaths are preventable, according to the Centers for Disease Control.
Blame a health system that has too long ignored the fate of these moms for some of the problem. Studies have shown too many doctors aren’t listening to women when they complain about pain. Others aren’t prepared for the complications that can arise during birth. Much needed attention has been showered on the health of the baby, but it has sometimes come at the expense of the vitality of moms. There needs to be more balance.
Far too many moms also still don’t have adequate insurance. That means they aren’t getting pre-natal care or aren’t being monitored during their pregnancy. If a doctor can catch high blood pressure early, they can keep a mom alive.
Thankfully, more is being done to try to change the pattern. Bipartisan legislation recently passed the U.S. House of Representatives that would help states establish mortality review boards to better track pregnancy-related deaths to get a clearer understanding of the cause. We hope they can also come up with solutions to prevent them. Under the legislation, states would get federal funding to help with the efforts. The American College of Obstetricians and Gynecologists supports such boards. The U.S. Senate now needs to follow suit and enact the same legislation.
The state of Maryland is ahead of the curve, already having established such a board under the state’s department of health. But its maternal death rates are still too high.
Maryland’s rate of maternal deaths was 26 deaths per 100,000 births for the five-year period 2011 to 2015, according to its review board. Black moms die due to pregnancy 2.7 times more than white moms in the state. The state’s rate has generally been higher than the rest of the country, but it was slightly lower during the time period.
Substance abuse and unintentional overdose were the leading cause of maternal death in Maryland in 2015. Pulmonary embolisms were the second most common cause.
Nationwide, the deaths hit women of all socioeconomic backgrounds. Tennis great Serena Williams, wealthy and with access to the best doctors, suffered from blood clots that nearly killed her after giving birth to her daughter. Model Christy Turlington Burns, who spoke at the recent Johns Hopkins conference, started a non-profit devoted to maternal health after suffering postpartum hemorrhage after the birth of her first child.
Their stories are bringing needed attention to the issue and giving other mothers the courage to speak out.
The March of Dimes recently released a report that identified the country’s “maternity care deserts,” or places where moms-to-be have a hard time getting pregnancy-related health care services. Some grassroots organizations are trying to address the obstacles that stand in the way of low-income moms getting prenatal and pregnancy care, whether it be providing transportation or teaching them about good nutrition.
But still more needs to be done.
Other legislation pending in Congress would require federal health officials to develop a national strategy to end maternal deaths. The legislation calls for cutting in half the number of deaths in the next decade and eliminating them altogether by 2020. That would be a bold step that would make these deaths the priority they should be.
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