The maternal death rate in the United States is rising sharply, even as it has declined in other industrialized nations. Between 2000 and 2014, under the Bush and Obama administrations, the nation’s maternal death rate rose by 27 percent and is likely to rise even further.
Between 1990 and 2013, the U.K., Germany, Australia, Sweden, Japan, and South Korea have seen a dramatic decline in the number of deaths caused by childbirth. In Germany, for example, the rate is now just over a third of what it once was. But in the U.S., the number of deaths per 100,000 births has more than doubled since 1987, climbing from 7.2 to 15.9.
These deaths are not occurring for the same reasons they used to. Deaths due to excessive bleeding, which used to account for nearly a third of pregnancy-related deaths, have declined by almost a third and now only explain 11.4 percent of such incidents.
Dr. William Callaghan, chief of maternal and infant health at the CDC, told Vox that the rise of chronic diseases may be to blame for the spike. “We’ve seen a big bump in cardiovascular disease and chronic disease contributing to maternal deaths,” he said. “Underlying heart disease is common, diabetes is common. We now have a group of women bringing with them into pregnancy their entire health history.”
Cardiovascular disease and other chronic diseases are currently the top causes of death from pregnancy complications in the U.S. Three decades ago, they constituted only 10 percent. This change, as well as disparities between the U.S. and other countries, could be due to increased rates of hypertension, diabetes, and obesity among Americans, said Callaghan.
The data also show a huge racial disparity in pregnancy-related deaths, with black women more three times as likely to die from childbirth as white women, largely because of racial wealth gaps that prevent black women from obtaining adequate healthcare.
In addition to ensuring better access to reproductive care, more research needs to be done on the pregnancy-related complications women are now facing. Though we may think of health problems during pregnancy and childbirth as an old problem, they’re also presenting some new challenges, and medicine needs to catch up with them.
Laura F. Nixon