• Ashlee Knox

America's Maternal Mortality Rates: the Truth Behind the Rising Numbers

Despite having access to some of the world’s most innovative and successful medical technologies, the United States continues to rank worst for maternal mortality rates among other developed countries. The reality of giving birth in America is a grim one for mothers, especially those who are low-income, Indigenous, Black, or any combination of the three. This article will provide a brief overview of the statistics, racial disparities, factors contributing, and a proposed solution to the ongoing maternal health crisis in the U.S.


Maternal Mortality in the U.S



Data on maternal mortality rates in the U.S have proven to be both concerning in its upward trend and often results in faulty statistics resulting in a fatal underestimation of the current situation. According to the World Health Organization (WHO), the definition of maternal mortality is “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to aggravated by the pregnancy or its management”. Even with a clear definition of the term, developed countries still have an issue providing accurate data. America personally went 11 years (2007-2018) without producing an official maternal mortality rate. When the rate was exposed, data from 2018 showed that the rate was 17.4 maternal deaths per 100,000 live births. That is actually worse than the 2007 calculation which was 12.4 maternal deaths per 100,000 live births. Unlike other developed countries, America seems to be going backward in terms of healthcare for pregnant women. In fact, when ranked by WHO, the U.S falls behind Russia at 55th and when compared to similarly wealthy countries such as Germany the U.S ranks 10th.


The data is even more concerning for mothers of color such as Black women who are 3-4 times more likely to die during/after delivery than white women. The rate of maternal deaths for Black women in the U.S is comparable to mortality rates in impoverished countries such as Mexico and Uzbekistan. Furthermore, Indigenous American women and Alaska Natives are “2.3 times more likely to die than white mothers” and in urban settings, they are “4.5 times more likely to die.”

With these shocking statistics in mind, one must ask: why is the U.S suffering from such a health crisis?


How America Fails Its Mothers


One of the most difficult obstacles expecting mothers in the U.S has to face is the lack of both affordable and high-quality prenatal care. Mothers with issues such as hypertension, diabetes, and obesity face a particularly dangerous challenge when giving birth which is not eased at all by the inaccessibility of primary care for low-income women. Even when women are given access to high-quality prenatal care and primary care there are other systematic handicaps. These include the fact that America has no national protocol for the conditions that kill women the most before, during, and after birth resulting in an unprepared healthcare system. Moreover, there’s also a certain attitude carried by hospitals which favor the infant’s health over the mother’s because infants typically demand the most attention. This results in a system where hospital staff neglect the mother’s concerns and high-risk factors possibly leading to preventable maternal deaths. In one instance, Black mother Shalon Irving suffered from multiple symptoms after her c-section birth such as “a painful hematoma (blood trapped under layers of healing skin) at her incision, spiking blood pressure, headaches and blurred vision, swelling legs, and rapid weight gain.” She visited her primary care physician for all of these but was only assured that these were normal for new mothers. Hours after her last medical appointment she took her newly prescribed blood pressure medication and tragically died leaving her new-born daughter to be raised by her mother. Although Irving’s case was particularly unfortunate, it was not an isolated one as the maternal mortality rate only continues to increase in America. Considering that hospitals are currently spread thin by corona virus this may be the most hazardous period in modern history for expectant mothers to give birth.


Public Health Initiatives


Healthcare workers, politicians, and mothers alike are calling for the U.S to take definitive action towards this worsening public health crisis. One almost all-encompassing initiative is the Alliance for Innovation on Maternal Health or “AIM”. AIM is a program ran through the Council on Patient Safety in Women’s Health Care which is a non-profit organization dedicated to improving the health care of all women including non-binary and transgender individuals. AIM works with states and hospitals to implement data-based measures focused on increasing maternal health safety. The program is funded through a grant given by the federal government and employs several strategies to reduce maternal mortality including providing hospitals with: “broad partnerships, tools, and technical assistance, implementation training, real-time data,” and more. As of 2018, 17 states participated in AIM, and, as of 2020, more than 25+ non-profit health organizations partnered with the program. Beyond standard programs, AIM has also taken the time to craft an initiative centered around addressing racial disparities in women’s health care and creating strategies to ensure “staff education on racial and ethnic disparities in maternal health outcomes, shared decision-making, and implicit bias”. While it is obvious that AIM is a well-developed program backed by research, the question remains why only 34% of states employ this program despite its obvious successes. One reason may be that to participate in AIM, states must show a serious commitment to implementing the strategies provided and reducing maternal mortality rates. All 50 U.S states and the District of Columbia should consider joining AIM as a method to form partnerships that directly combat maternal mortality in their hospitals.


Conclusion


The U.S, the only high resource country in the world with growing maternal mortality rates, desperately needs to address this ongoing disaster with proven public health policies such as those presented in AIM. Expecting mothers - especially those who are low-income, Black, or Indigenous - face a dangerous situation when entering a hospital to give birth. America’s mothers are dying and more priority needs to be given to the women giving birth to our next promising generation.




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