16 April 2010

Maternal Health: Just the Stats

First in a series

Our country has just passed health reform (woohoo!). It was a long struggle that had to overcome a vicious partisan divide and public discontent. Now three weeks later, after people have taken the time to pat themselves on the back, it’s time to start thinking about what else we need to accomplish. All the problems with our health care system have not been solved by this reform. Some of the most serious ailments of the system continue to be under reported and rarely discussed within the political spectrum. Maternal mortality is at a stage of crisis in the United States. It’s an issue that has not been given much attention in the past and lacks extensive data and research. In early March, however, new attention was brought to the issue when Amnesty International USA published a report on maternal health, DEADLY DELIVERY: THE MATERNAL HEALTH CARE CRISIS IN THE USA as part of its ‘Maternal Health is a Human Right’ campaign. This in-depth report examines the state of maternal health in the United States and offers ways to improve the system. This is the first in a series on maternal health based off information from this report and other sources.

The title of the report labels the maternal health in the United States as a crisis. You might think that the language is a bit of a hyperbole, that we aren’t really in a crisis. Well, I urge you to take a look at the data and then reconsider. Before I begin to type out a series of horrific and startling numbers, I should probably clarify what maternal health and maternal morality are. Maternal health is comprehensive care including family planning, preconception, prenatal, and postnatal care. Maternal mortality occurs when a woman dies during or shortly after her pregnancy.

In the United States, two women die everyday from maternal mortality, the 41st worst ranking in the world. Our maternal mortality rate is higher than any highly developed nation, but we spend the most on health care. Like people have been saying about the health care system for years… something doesn’t seem to fit. The disparity between the U.S.’s maternal mortality rate and the countries ahead of us is no small amount. Ireland has the smallest rate in the world at 1 in 47,600. America’s is 1 in 4,800. That’s almost 10X the difference. How can it be that a comparably developed country takes so much better care of its pregnant women?

The maternal health care crisis goes beyond maternal mortality and encompasses the numerous other health problems associated with pregnancy. Every year 34,000 women experience “near misses,” instances where a woman almost dies from a maternal health issue. Even though these women do survive, it is unacceptable that every single day 94 women face a serious risk of death, when we have the technology and resources to prevent many of these complications and problems. I wish I could say that that’s the extent of the problem, but the numbers continue to roll. 1.7 million women in this country, almost a third of the pregnant women in a given year, suffer from complications and adverse health effects from their pregnancy. In the past twenty years, these rates have not improved, clearly revealing the political and social apathy toward maternal health. Because the system is not working to protect them, Women in this country are becoming ill, dealing with life threatening health problems, and even dying.

Maternal mortality can effect any woman, but hidden in the general data are the racial and class disparities that make maternal health an issue of discrimination. The rates of maternal mortality are extremely disproportionate among minorities. Black women are four times more likely to die from pregnancy related illnesses than white women, and the lack of prenatal care that many women of color receive puts them at a much higher risk of developing a maternal health problem. Native American and Alaska Native women are 3.6 times more likely than white women to receive late or no prenatal care, and Latina women are 2.5 times more likely. Not receiving proper care throughout the pregnancy is dangerous to both mother and child and is often associated with maternal morality..)

Although they can be shocking, right now, these statistics are numbers that stand without a firm context. To have a comprehensive understanding of the issue, it is necessary to know what causes maternal mortality and why women are not receiving the proper care they need. These topics will be explored in the second part of the series to be posted later. Check back soon!

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