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Why Does the U.S. Have the Highest Maternal Morbidity Rates in the Industrialized World?

Figures from the Centers for Disease Control and Prevention indicate that approximately 50,000 women a year in the U.S. suffer life-threatening complications giving birth – and as many as 900 of those women die. Those who survive often wind up disabled, traumatized and/or sterile.

To add insult to injury, many are left with thousands of dollars in unnecessary medical expenses. Such events were not uncommon a century ago. Today, such complications happen in just over 1% of childbirths – but considering this is the 21st Century and ours is supposedly one of the most advanced nations on the planet, the number of such cases is unacceptably high. Furthermore, it's costing society billions of dollars.

What's worse is the problem is growing. According to the World Health Organization, the rate of maternal mortality in the U.S. increased by 115 percent between 1990 and 2013. Tragically, half of those deaths were preventable. At the same time, the rate of maternal morbidity – complications that, while not necessarily fatal, are serious and life-threatening – continues to rise even faster than that of fatalities. A study published in the October 2016 edition of the American Journal of Obstetrics and Gynecology found that in 44 percent of cases, these complications could have been prevented with better care.

The WHO report noted three factors involved in the rising rates of maternal morbidity. One is the lack of consistency when it comes to obstetric practice across the country. As a result, complications in pregnancy that could lead to emergencies in the delivery room are not identified until it is too late.

Researchers who have studied the issues have found that in too many cases, doctors and nurses fail to recognize problems, primarily because they are unexpected. Ironically, there is also the flip-side – well-meaning doctors who, out of concern for the mother's health, go too far by inducing labor or performing unnecessary C-sections, all of which can cause added stress and dangerous complications.

Another reason is the growing number of expectant mothers who suffer from chronic conditions that can cause a difficult pregnancy – including diabetes, obesity and high blood pressure. Some of this has been mitigated due to the Affordable Care Act, which has made prenatal care services more accessible, particularly for low-income women. Unfortunately, given the priorities of the current government, such services may once again become difficult for such women to obtain.

One disturbing aspect of this issue is the scarcity of reliable data on maternal health outcomes. The federal government stopped keeping track of maternal mortality figures in 2007. Furthermore, most of the interest – particularly among conservative elements in government and society – is focused on pregnancy. Once the child is born, there is little interest in what happens to the mother (or the child, for that matter). As a result, these cases get lost in the system.

Maternal mortality and morbidity in the U.S. is, for most cases, completely preventable. Policymakers and legislators who constantly go on about the “sanctity of life” need to acknowledge the value of those lives after mother and child leave the delivery room – and if nothing else, consider the astronomical costs to families and society when these mothers are not properly cared for.

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