The Guardian • Issue #2047

US maternal death rate highest in developed world

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According to a recent report by the US Centers for Disease Control and Prevention (CDC) maternal mortality rose by 40 per cent at the height of the COVID-19 pandemic. The CDC defines maternal mortality as a death that occurs while pregnant or within 42 days of the end of a pregnancy. The majority of maternal deaths happen shortly after giving birth, when many women return to work, unable to pay for post-partum care.

In the USA the death rate increased to 33.0 women dying per 100,000 live births in 2021, up from 23.8 in 2020. The death rate of Black mothers was three times that of white women. Black women are often employed in low-income jobs that offer little or no health insurance coverage and allow minimal time off with pay for maternity leave. They often work in industries with high chances of exposure to COVID-19, contributing to their higher death rate. In the UK and Europe, the medical procedures associated with childbirth are free. In the US childbirth costs thousands of dollars, even for those covered by insurance. Insurance payments towards pregnancy screenings and post-natal care are minimal.

The maternal mortality rate in the USA was twice that of the UK, Germany and France, and three times higher than in Spain, Italy and Japan. The rate in the USA has been consistently increasing since 2000, while the maternal mortality rate among 37 other developed countries has declined over the same time period.

Joan Costa-i-Font, Professor of Health Economics, Department of Health Policy at the London School of Economics, said much of the blame goes to the systemic problems of high healthcare costs and to the persistent racial and socio-economic divides in the US. This means that low-income populations have higher needs, due to poor health and preventable diseases. Poor diet and limited exercise lead to a high rate of obesity, meaning they have a 20 per cent higher chance of hypertension and heart disease. According to Dr Rochanda Mitchell, “Women are saying, I can’t come in for this bleeding, for this headache, because I don’t have the support afterward.” Without the systems in place to support low-income workers, mothers are forced to ignore these serious health warnings. As the CDC analysis shows, more than 80 per cent of maternal deaths are preventable. There is a need for a vast overhaul of the US health care system.

Further Reading:

US Centers for Disease Control and Prevention (CDC). Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 2017–2019

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