Category Archives: Maternal Health in the US

Our ongoing article and interview series follows maternal health and mortality news in the United States.

Why Congress Needs to Pass the Maternal Health Accountability Act of 2014

The United States has a maternal mortality problem. For the past 25 years the rate of maternal mortality has increased dramatically in America. In fact, the United States is one of eight countries including Greece, Afghanistan and sub-Saharan African countries where the number of mothers who die during childbirth is on the rise. Now each year, on average, 800 American women will lose their lives giving birth. Last year 1200 women died during childbirth in the United States, up 500 deaths since 2005.

To put this crisis into perspective globally, the United States has double the maternal mortality rate of Canada and three times the maternal mortality rate of France. When comparing maternal mortality rates with the Nordic countries it just becomes even more embarrassing.  What’s worse, the United States has the highest maternal mortality rate of any industrialized country in the world.

See rates and statistics in Trends in Maternal Mortality: 1990 – 2013

What is especially disheartening about these statistics is doctors and researchers are baffled about why many mothers are dying during childbirth when they are afforded access to the best medical care in the world. Some point to the increased rates of diabetes and hypertension in overweight or obese women as reasons for the increased rate of maternal mortality. Others blame healthcare disparities and the rate of older women who are now having children. The problem is there is no definitive science on why more mothers are dying in the United States than any other developed country in the world.

What experts do know is that African-American women are three times more likely to die during childbirth. A recent study conducted by the California Department of Health found that the maternal mortality rate for African-American women was 46 per 1000,000 live births. For Asian and Caucasian women, the rate was 13 per 100,000 live births between 2003 – 2008.

“African-American people generally have worse health outcomes than Caucasian people…but not to this degree, not four-fold,” said Conrad Chao, a clinical professor of obstetrics and gynecology at the University of california, San Francisco.

Timoria McQueenTimoria McQueen, an African-American woman, suffered a postpartum hemorrhage after the birth of her daughter. She subsequently underwent a three-hour life-saving surgery to survive. Now, McQueen is a staunch maternal health advocate pushing to amend Health and Human Services’ Title V Maternal and Child Health Services Block Grant Program with the proposed Maternal Health Accountability Act of 2014 (H.R.4216).

The Maternal Health Accountability Act of 2014, if passed, would require:

(1) mandatory reporting to the state department of health by health care providers and other entities of pregnancy-related deaths;

(2) establishment of a state maternal mortality review committee on pregnancy-related deaths occurring within such state;

(3) implementation and use of the comprehensive case abstraction form by such committee to preserve the uniformity of the information collected;

(4) annual public disclosure of committee findings; and

(5) collect, analyze, and report to the Secretary cases of maternal morbidity

The Act was introduced in the House in March 2014, but has stalled in Congress since.

How You Can Raise Your Voice

To find out how to contact your local Congress person and support H.R.4216: The Maternal Health Accountability Act of 2014 click here

Maternal Mortality in the US: The Numbers May Surprise You

When we talk about sky-high maternal mortality rates we tend to look more closely at low-income countries like Afghanistan, Chad and Somalia that have the world’s highest maternal mortality rates in the world according to the World Bank. And, of course, sub-Saharan African countries need to desperately bring their numbers down. But when you look at rich, developed countries the United States has the highest maternal mortality rates among them and the rates are not declining. In fact, maternal mortality rates in the United States have doubled over the past 25 years. African-American women are 3x more likely to die during childbirth in the United States. And, Caucasian women are more likely to die during childbirth than women in 24 other industrialized countries. 21 mothers die per 100,000 live births in the United States. Compare that to Greece (3), Finland (5), and even the United Kingdom (12) deaths per 100,000 live births.

This year as we report on maternal mortality we will also include the United States in our news reporting because the numbers are high, increasing, and are baffling researchers and doctors. They do not know concretely what is causing the doubled maternal mortality ratios although they suspect obesity, high blood pressure, heart disease, health care disparities, and older mothers may be causing the steady spike in numbers in the United States.

According to Amnesty International the five main reasons women die in childbirth in the United States are:

  1. Embolism 20% – A blood clot that blocks an essential blood vessel, for example in the lungs
  2. Hemorrhage 17% – Severe blood loss
  3. Pre-eclampsia and eclampsia 16% – Disorders associated with excessively high blood pressure
  4. Infection 13%
  5. Cardiomyopathy 8% – Heart muscle disease

And, according to Merck for Mothers, a woman nearly dies in childbirth every two minutes, that is more than 50,000 women annually. See infographic. Around 650 women die during childbirth or shortly thereafter based on numbers from the CDC.

UNited States

As we continue to report on maternal mortality around the world where the rates are in the hundreds per 100,000 we will not forget about the mothers who are also dying here in the United States, a country that spends the most in the world on health care.

Photo: Fotolio