Here’s troubling news: The United States has got the worst maternal death rate of any developed nation, according to the Centers for Disease Control and Prevention. And we’re one of the only industrialized countries in which the number of deaths are on the rise.
According to the CDC, about 700 U.S. women die every year as a result of high-risk pregnancy or delivery complications, while up to 50,000 women nearly die due to severe complications such as heart attacks or hemorrhages during pregnancy or delivery. (That’s despite the fact that, according to 2017 research published in The Lancet, the United States spends more money on healthcare than any other country does—around $9,237 a person each year.)
Even scarier: According to the World Health Organization, about half of maternal deaths in the U.S. are preventable, so long as there’s increased awareness and pregnant women can get access to quality care. And the situation’s just getting worse: the latest stats show pregnancy-related deaths jumped by almost 27 percent from 2000 to 2014, according to a report published in the journal Obstetrics and Gynecology, despite the fact that our infant mortality rate is at an all-time low, having declined by 15 percent over the past decade, according to the CDC.
“We have a healthcare structure where we focus so much on a safe birth and the health of the baby, that we’ve lost sight of the health of the mother,” says study author Eugene Declercq, Ph.D., a professor of community health sciences at the Boston University School of Public Health. Here’s what’s going on behind the scenes:
Black women are a staggering three to four times more likely to die in pregnancy or childbirth than white women, according to the CDC. In fact, the maternal death rate for black women in the U.S. is close to what you might find for Uzbekistan and Mexico as a whole.
Experts point to disparities in socioeconomic status, access to healthcare (for example, a study last year found that black women are more likely than white women to deliver in hospitals that have a higher maternal mortality rate), education, and insurance coverage (a doozy—more on that below).
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A whopping 44 percent of all births in the U.S. are covered by Medicaid (our government-funded healthcare) because pregnant women qualify for coverage at higher income levels than non-pregnant women. (On average, you can make up to 200 percent of your state’s poverty level to qualify for Medicaid while pregnant.)
The problem: “We don’t know how quickly women are getting into the system when they become pregnant, and they’re thrown off it right after the baby is born,” says Declercq. “We have a lot of women slipping through the cracks.” Without coverage, many women miss their follow-up appointments post-birth, when issues such as infections and postpartum hemorrhage (major causes of maternal deaths) could have been identified or treated.
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Half of women who delivered babies in 2014 were either overweight or obese before becoming pregnant, putting them at greater risk for issues such as heart disease, hypertension, or diabetes, all of which can trigger complications during pregnancy and childbirth. (In fact, one in four pregnancy-related deaths are related to heart conditions.)
“This is a public health dilemma—we have women who aren’t cared for early enough, or their conditions aren’t identified before pregnancy, which puts them at a much greater risk,” says Declercq.
It’s a (totally unfair) biological fact of life: Women are delaying pregnancy, but as the years go by we’re more likely to have high-risk pregnancies, along with those chronic conditions mentioned above like heart disease and obesity that can lead to a rocky pregnancy or birth.
Research shows that women ages 35 to 39 are almost twice as likely to die of pregnancy related complications as women ages 20 to 24, and for women over 40, the risk is even higher.
Around one in three women give birth by cesarean delivery (a rate that increased from 26 percent to 36.5 percent between 2003 and 2009, according to one study) and it’s most often done for good reason—to protect the life of the mom and baby. And while research shows that only about 3 to 4 percent of cesarean deliveries are elective (or performed earlier than medically needed), 4 million births occur in the country every year. So that’s still a substantial chunk of women opting for intensive surgery that could put their health at risk.
Maternal morbidity is higher with Cesarean deliveries compared to vaginal deliveries across all groups of women because of potential complications such as hemorrhage and infection.
To keep yourself safe and healthy during pregnancy, it’s important to be your own health advocate. As early as possible (and even before trying to get pregnant!), focus on following a healthy diet rich in whole foods, being physically active, and avoiding substances including tobacco. Also try to address any existing health issues with your doctor before getting pregnant, and keep you calendar marked for regular visits with your ob-gyn throughout the course of your pregnancy, recommends the CDC.
Source: Women’s Health Mag