10 Reasons Why The Maternal Mortality Rate Is Higher In The U.S. Than In Other Developed Nations
At What to Expect, our mission is to support happy, healthy pregnancies and happy, healthy babies. That’s why we’re teaming up with International Medical Corps to raise awareness for an issue that everyone needs to know about: the sky-high maternal mortality rate here in the United States. On Wednesday, July 17, 2019 help us spread the word by posting a photo of your pregnant belly (current or past) and tag it #BumpDay.
If you’re pregnant or trying to conceive, you might have noticed that maternal mortality rates in the U.S. have been getting a lot of attention lately. And for an important reason: The number of American women dying from pregnancy-related complications has more than doubled since 1990 — while rates in other developed countries have been going down.
Before you get too freaked out, keep in mind that the overall numbers are still very, very low: Maternal mortality affects 18 out of every 100,000 births. Still, research shows that the majority of these deaths are preventable. So, what exactly is going wrong?
The answers are complex, of course. On the other hand, knowledge is power. The more information health care providers, women and their loved ones have about pregnancy-related complications and factors that affect maternal mortality, the more we can do to protect the health of new moms and moms-to-be.
Here’s a look at some of the most prominent factors affecting the higher maternal mortality rate in the U.S. — plus, what women can do to stay safe.
1. More moms-to-be have chronic diseases
The health of the population — including pregnant women and new moms — is changing. Chronic health problems like obesity, heart disease, high blood pressure and diabetes are more common than they used to be, and all of these can raise the risk for pregnancy-related complications. After all, pregnancy is like a natural endurance test. So, if the body is already experiencing other stressors, problems may be more likely to strike.
2. Women of color often don’t get the same treatment as white women
There’s a major disparity in how black women are treated for pregnancy-related complications. Their health concerns are more likely to be ignored or minimized, and they’re more likely to have risk factors like diabetes, high blood pressure, late prenatal care and obesity. In fact, findings show that black moms are three-and-a-half times more likely to die in childbirth or of pregnancy-related complications than non-Hispanic white women, while Native American and Alaskan Native women are two-and-a-half times more likely.
3. Women need more education about serious warning signs
Symptoms like very heavy bleeding, trouble breathing, chest pain or a bad headache are all red flags that could indicate a serious or life-threatening complication like postpartum hemorrhage or a heart condition. But reports show that not all women and their families are aware of these warning signs. That could make them less likely to seek the immediate medical care that they desperately need.
4. We have work to do on mental health issues
Perinatal mood disorders affect 15 percent of U.S. women during pregnancy and the postpartum period. And while it’s scary to think about, suicide ideation occurs more in pregnant women and new moms than in the general population — especially during the late postpartum period (43 to 365 days after giving birth). Hormones can have a major impact on mood, but there are plenty of other factors that need to be considered. Social isolation and lack of social support, racism, poverty and lack of access to insurance, transportation or health care providers all play a big role, experts say.
5. Opioid addiction is a big problem
The use of opioids during pregnancy quadrupled from 1999 to 2014, mostly due to overprescribing practices, CDC data shows. It’s no secret that drugs like oxycodone, hydrocodone and codeine can be highly addictive — and new moms who struggle with substance addiction are at a greater risk for overdosing. For instance, research shows drug-induced death is the most common cause of pregnancy-associated deaths in Utah, with 80 percent of the deaths occurring after a woman’s postpartum checkup.
6. We have more barriers to quality care
Compared to countries with nationalized health care, our own fragmented system can be tougher to navigate. Pregnant women or new moms with Medicaid or who don’t have health insurance might not know where to find free or affordable care. And that can make them less likely to receive treatment for pregnancy or postpartum complications — including ones that could be life-threatening.
7. We don’t devote enough resources to maternal health
Both federal-state grant programs and Medicaid devote significantly more funding and coverage to babies than to new moms. And while the U.S. is getting better at creating standards to reduce pregnancy-related complications, the vast majority of them focus specifically on infants. Compare that to the United Kingdom, where the National Health Service recently announced the rollout of a blood test for preeclampsia that can reduce maternal stroke, seizure and death rates by 20 percent. While California has a preeclampsia toolkit that’s made strides in improving maternal health, we don’t have something like that nationwide.
8. Some other countries are more likely to look into what went wrong — and how it can be prevented next time
When a woman in the United Kingdom dies of a pregnancy-related complication, a national committee analyzes the details of her death — including reviewing her medical records, interviewing family members and even asking hospitals and health care providers to explain what went wrong. The information is compiled into a public report that’s used to improve care policies across the country. Though some cases are reviewed here at home, not every maternal death gets this kind of deep dive.
9. Care is less likely to be coordinated among different providers
As chronic health conditions among U.S. pregnant women become more commonplace, their care may need to be managed by more specialists. And each of those specialists might keep their own health records for patients. That adds up to more chance for miscommunications among a woman’s care providers or important details falling through the cracks. And that could cause a woman to miss out on essential information about her health or treatments — or even mess up details about her care.
10. Women may be misdiagnosed or get ineffective treatments
Take preeclampsia, for example. There’s no simple diagnostic test for the condition here in the U.S. So, some providers might not recognize the warning signs until its too late — resulting in dangerous delays in treatment. These kinds of problems may be less likely in places like the United Kingdom, thanks to the rollout of a new preeclampsia blood test. Slow or wrong diagnosis or inaccurate treatments — including the failure to have patients consult with a cardiologist — have been shown to impact maternal mortality rates, too.