The maternity death rate in the U.S. is abominable

Posted at 4:45 PM Mar 12, 2010

By Andrea Grimes

A couple weeks ago, I was leaving the lecture hall where I'm a T.A. for a cultural anthropology class. We'd just gotten done talking about language and metaphor and the way language shapes behavior, particularly medicine. The prof talked a lot about the mechanization of birth, and one of my students was unconvinced. "But Western medicine saves lives. Who is going to argue with that?" he asked me. I told him what little I knew--that I thought unnecessary C-sections and inadequate application of the Great White Wonder That Is Western Medicine has made birth a doctorly--rather than a motherly, or midwiferly--business. My student remained unconvinced.

You can be sure, then, that I will forward him and the rest of my kids this article, detailing an Amnesty International study that reports maternity deaths as doubling over the past 20 years. You know, the past 20 years in which medical science has advanced by leaps and bounds.

Deaths from pregnancy and childbirth in the United States have doubled in the past 20 years, a development that a human rights group called "scandalous and disgraceful" Friday. In addition, the rights group said, about 1.7 million women a year, one-third of pregnant women in the United States, suffer from pregnancy-related complications. Most of the deaths and complications occur among minorities and women living in poverty, it noted.
Health care reform? Who needs it? Not us, clearly.

"Good maternal care should not be considered a luxury available only to those who can access the best hospitals and the best doctors. Women should not die in the richest country on earth from preventable complications and emergencies," Cox said in a news release.

The report, "Deadly Delivery: The Maternal Health Care Crisis in the USA," notes that the lifetime risk of maternal deaths is greater in the United States than in 40 other countries, including virtually all industrialized nations.
And yet, as we see with my student, the idea that science and progress always know what's best still dominates. Fact is, and this report demonstrates it, very few mothers in the United States have access to the "best" medical care in the whole world--that of the American medical system. Indeed, even monied, healthy women have incredible trouble convincing insurance companies to cover basic care.

More info, via Time mag:

... approximately half of the pregnancy-related deaths in the U.S. are preventable, the result of systemic failures, including barriers to accessing care; inadequate, neglectful or discriminatory care; and overuse of risky interventions like inducing labor and delivering via cesarean section. "Women are not dying from complex, mysterious causes that we don't know how to treat," says Strauss. "Women are dying because it's a fragmented system, and they are not getting the comprehensive services that they need."


JenX said:

Many women are preyed upon by doctors who assume that pregnant women are stupid. With my first pregnancy, I did everything they told me...then later found out that most of what they told me was b.s. With this pregnancy, I did a LOT of screening before picking an OB out. It also helps that I'm in a completely different state (first birth was Utah, I'm now in Michigan). My first pregnancy, I was in constant fear of doing ANYTHING other than sitting still and waiting for birth. I was made to feel guilty about working on my feet, and walking to and from work (Hello, 3 blocks?). With this one? I have a group of doctors who understand that life happens, pregnancy is a part of it, and they do everything to undo the b.s. I got 10 years ago. I exercise. I work (albeit, this time, on my butt). I do stupid things like trip and fall in the ditch outside my house, faceplant, and break my glasses (so, yeah, it's true that you get clumsy when you're pregnant). When I complain about something, I don't get a battery of tests. I usually get a "suck it up, pumpkin!" I LOVE THAT. They respect that I will have NO c-section, unless I'm REALLY RIGHT NOW about to die. They respect that my husband is a huge wuss with blood, so he's probably not the best candidate to "help out" in the delivery room. They also respected me enough to revisit my due date, after making it clear that what I was going through was best described, by them, as happening *later* in my pregnancy, took measurements, did another ultrasound, and recalculated my due date.
They could have just shoved me off. They didn't. Which is awesome. I'm one of the rare lucky ones with a good team of doctors. (You don't get to insist on YOUR DOCTOR being there at the practice I go get whoever's on call.) I have friends who aren't and weren't as lucky as me. That is a tragedy.

Lex said:

Gee, It might not have anything to do with all the THIRD WORLD breeders from Mexico this country has in it now, right?

Sara said:

I wonder if the increase in pregnancy complications has anything to do with the subsequent rise in obesity and diabetes over the same time period.

Seminymous Coward said:

Lex: Yes, it must be those people from Mexico (and Central and South America). If we assume that quick enough, we won't even have to read how black women die from pregnancy at 344% the rate of whites. If we assume that hard enough, we can even pretend (right? ...right?!) we don't care if immigrants die.

Sara: concurrent?

Andrea said:

Lex -

Well, no, it doesn't have anything to do with "all the THIRD WORLD breeders from Mexico this country has in it now," and if you had read the article instead of being an ignorant racist, you would know that. Then again, thinking is hard and usually leads to things like not being racist, so I can understand how you'd skip it. What the article said was that it is the American health care system, with its bureaucracy, insurance issues and overall expense that prevents women from getting the care they need.

Racquel said:

I personally disagree with you. I have an angle, of course, and in the interest of full disclosure, I must admit that I am a medical student, and have studied the history of prepartum/intrapartum care over the past century and have to assert that modern medicine has prevented the mortality of many women. While I will agree that maternal mortality is higher than we would like, I would be lying if I stated that it hasn't prevented the deaths of many more women. I'm currently on an ob/gyn rotation where, without the administration of modern medicine many of these patients could have seized, or bled out postpartum, contracted a raging infection, or simply not progressed in labor. I understand your point about medicine being considered a luxury in this country, but it is only fare to say that maternal mortality is correlated with the modern medicine, not causal.

Seminymous Coward said:


You have a very strong sampling bias towards patients receiving healthcare.

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