When one thinks of countries with women dying in childbirth, the United States is not a country one would expect to have an increasing problem. But it does. The U.S. is one of just eight countries in the world that have seen rising maternal deaths (women dying in childbirth) in the past decade!
Believe it or not, the U.S. has fallen behind most high-income countries. The disturbing trend has the U.S. listed with Afghanistan as well as countries in Central America and Africa that have worsening rates since 2003, according to a study from the University of Washington’s Institute for Health Metrics and Evaluation (IHME).Globally, maternal deaths declined by average 2.7 percent per year since 2003.
The study looked at causes and levels of maternal mortality on a global, regional, and national basis from 1990 to 2013. The results, published May 2 in The Lancet, ranked the U.S. number 60 on maternal deaths out of 180 countries. Demonstrating how far the country has fallen behind globally, it was ranked number 22 in 1990. By contrast, China rose to number 57 from 116 during the same period.
In 2013, 18.5 mothers died per 100,000 live births in the U.S. This mortality rate was more than double rates in Saudi Arabia (7 per 100,000) and Canada (8.2). It was three times the rate for the United Kingdom (6.1).
The American age group that experienced the largest increase in maternal mortality was women between the ages of 20 and 24. During 1990, 7.2 women in this age band died for every 100,000 live births whereas 14 died in 2013.
The study merely measured the trends in maternal mortality. However, the researchers offer some possible explanations for the maternal health disparities between the US and other countries, and the rising number of deaths, including inaccessible prenatal care, high rates of caesarian deliveries, and pregnancies complicated by obesity, diabetes, and other health conditions. The continued rise may reflect “the performance of the health system as a whole” compared with other developed countries, notes study author Nicholas Kassebaum. who is assistant professor at IHME. It also may reflect health problems in U.S. women, he said, adding that in most cases maternal deaths are preventable.
The primary cause of maternal death worldwide is medical complications in childbirth and the period post-delivery. Approximately one-quarter of maternal deaths occur during childbirth or during the 24 hours following delivery. Another 25 percent occur during pregnancy, and the remaining deaths within the first year.
The U.S. Centers for Disease Control and Prevention (CDC) previously reported the maternal mortality rise. The CDC noted that growing numbers of U.S. women enter pregnancy with conditions such as hypertension, diabetes and heart disease, which puts them at higher risk for complications and death. One example cited by the CDC was the increase in maternal deaths in 2009 because of the H1N1 swine flu pandemic.
While the IHME study showed rising maternal mortality rates in the U.S., the research found that, globally, maternal deaths dropped significantly between 1990 and 2013. However, 293,000 women died from pregnancy-related causes in 2013. In the US, the total was 796 women.
By Dyanne Weiss