When one thinks of mothers dying during childbirth, the United States is probably not a country that comes to mind. It’s common knowledge in the international community that a large majority of maternal deaths occur in developing countries. The World Health Organization reports steady progress in the reduction of maternal deaths since 1990, with a 45% global decrease. However, when looking at the figures specific to the U.S., the statistics tell a different story.
The U.S. is the only developed country in a group of eight where maternal deaths have increased between 2003 and 2013, according to the Institute for Health Metrics and Evaluation. In 1990, the maternal mortality ratio was 12.4 deaths per 100,000 live births. In 2013, this number is much higher at 18.5 per 100,000 live births, which the Lancet suggests is underreported. The report ranks the U.S. 60th for maternal death on a list of 180 countries, meaning 59 countries are doing a better job at keeping their mothers alive than we are.
Most alarmingly, some of America’s cities suffer higher rates. The city of Detroit has a maternal death rate triple the national average. Between 2008 and 2011, Detroit’s maternal mortality ratio averaged a disturbing 58.7 per 100,000 live births. This number is even more startling when compared to the rates of similar developed countries. From 2009-2013, the maternal mortality ratios of the United Kingdom and Sweden averaged 8 per 100,000 live births and 4 per 100,000 live births, respectively.
The hardest thing for me to grasp when seeing these numbers is the fact that many of the causes of maternal death are preventable. Women die as a result of major complications of childbirth, including severe bleeding, infections, and high blood pressure (leading to eclampsia). In the developing world, these causes could be attributed to lack of resources, among other factors. However, in the U.S., we have well-equipped facilities and skilled health care providers. We are the country that spends more on health care than any other developed country (17.9% of GDP, according to World Bank), and we have the resources to prevent maternal mortality.
So then, my question is: why are they still dying? [inlinetweet prefix=”” tweeter=”AmeriCares” suffix=””]This upward trend in maternal mortality likely reflects some inequalities in the health care system[/inlinetweet]: a complex combination of lack of access, poverty and ethnic/racial disparities. To put this into perspective, the CDC (2003) reports that African American women in the U.S., regardless of education level, had maternal mortality ratios that were three to four times those for white women.
One of the many rewards I’m finding as part of my internship at AmeriCares this summer is seeing the work that the organization is doing to help lower rates of maternal mortality both in the U.S. and abroad. As an example, within the U.S. partner network for FY14, AmeriCares provided enough prenatal vitamins and folic acid to fill about 200,000 prescriptions. Abroad, AmeriCares works with partners in countries such as Afghanistan, where we provide safe birthing kits at Afshar hospital, just outside Kabul.
[inlinetweet prefix=”” tweeter=”AmeriCares” suffix=””]To improve the maternal mortality ratio, maternal health must be a priority. [/inlinetweet]