“Even if the CDC data isn’t perfect, many scholars agree that far too many people are dying during and after childbirth in the United States.
We have many sources of information about maternal mortality, said Laurie Zephyrin, a senior vice president for advancing health equity at the Commonwealth Fund. The CDC’s National Center for Health Statistics releases the numbers that have been most debated recently, but the agency also has a Pregnancy Mortality Surveillance System that employs medical epidemiologists to comb through death records from pregnancy up to a year after birth. Meanwhile, state and local maternal mortality review committees also independently investigate maternal deaths. “All three of these ways of collecting data are showing that we have a problem in this country,” Zephyrin said.
We can also understand US maternal health better by putting it an international context. Comparing maternal mortality across countries can be complex, for some of the same reasons it’s complicated to count maternal deaths within the US. Some countries use a pregnancy checkbox like the one added in the US while others do not, leading to concerns that other nations may be underreporting maternal deaths, making the US look worse by comparison.
However, we know that the US lags behind other countries when it comes to policies proven to improve maternal (and overall) health. Among wealthy countries, the US is the only one without universal health care, said Munira Gunja, a senior researcher with the Commonwealth Fund’s International Program in Health Policy and Practice Innovations. It’s also the only one without federally mandated paid parental leave, and it’s the only country that doesn’t provide home visits and other comprehensive postpartum care, instead often limiting birthing people to a lone doctor’s appointment six weeks after birth. “The US is a clear outlier, particularly when it comes to postpartum support,” Gunja said.
Meanwhile, everyone involved in the debate over counting maternal deaths agrees that Black birthing people are dying at a disproportionately high rate. That disparity shows up whether you use the CDC’s method or Joseph’s, and it’s indicative of bigger problems within the US health care system, experts say. Black Americans in general have a lower life expectancy than white Americans, and Black babies are more likely to be stillborn or die in infancy. “This is across the board, not just in maternal health,” said Angela D. Aina, co-founder and executive director of the Black Mamas Matter Alliance.
Some have argued that the language of “crisis” is unproductive, frightening pregnant people and prospective parents and clouding the search for solutions. “The constant drumbeat that maternal mortality is ‘commonplace’ and that pregnancy is ‘deadly’ doesn’t empower me with information to make my own decisions,” Jerusalem Demsas writes at the Atlantic. “It just stresses me out.”
Reasonable people can disagree over what constitutes a crisis and over the best way to measure how often Americans experience the tragic situation in which a person who is already sick dies from their illness after giving birth.
But experts do not disagree on the basic premise that too many pregnant and birthing people are dying in America, that many of their deaths are preventable, and that we already know some of the reforms — from paid leave to better prenatal and postpartum care — that would save their lives.”
Millennials & Gen-Z are Poorer Than Ever (Here’s Why) Humphrey Yang. 2023 5 17. Have the Boomers Pinched Their Children’s Futures? – with Lord David Willetts The Royal Institution. 2020 1 23. https://www.youtube.com/watch?v=ZuXzvjBYW8A Some numbers at beginning for UK and Europe. The
“A new study out of Finland reaffirms this general rule in a very specific way. The Finnish government randomly awarded work subsidies to men and women. The finding is a bit awkward in these days of gender equity: If you subsidize work for men, birthrates go up. If you subsidize work for women, birthrates go down.”
“Over the last 30 years, nearly every wealthy country in the world has made it much safer for people to have babies. Only one outlier has moved in the opposite direction: the United States, where the rate of people dying in childbirth continues, stubbornly and tragically, to rise. In 2021, 1,205 US women died from birth-related causes, up from 754 in 2019. Many of those deaths — a full 89 percent in one Georgia study — are potentially preventable with the proper care.”
“The researchers used birth data, by age and race, from the Centers for Disease Control and Prevention from 2005 through June 2023. They used a statistical method that compared states with similar trends in births before the Dobbs decision to estimate how much a ban changed the expected birthrate. This increased their certainty that the change was because of the policy and not other factors.
They found that births increased 2.3%, on average, in states with bans relative to states where abortion remained legal.
The analysis showed that the increased births were disproportionately among women in their 20s and Black and Hispanic women, which researchers said could be because these groups tend to be poorer, making it harder to travel. They are also the demographic groups that have tended to be more likely to seek abortions.”
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“The researchers said these trends could change as more birth data becomes available. The women giving birth in the first half of the year would have already been pregnant when abortion bans began, or they became pregnant soon after. Since the data ended, there have been new restrictions on abortion in some places, and access has expanded in others.
Births could decline. New shield laws aim to legally protect providers who mail abortion pills to states with bans, and people might be changing their behaviors around sex and contraception in response to bans. Or births could increase as more states restrict abortion; some of this might depend on the outcome of a case to restrict the mailing of one of the two abortion pills.
“The abortion landscape continues evolving,” Pineda-Torres said. “People are adjusting, providers are adjusting, laws are adjusting.””
“in 2022, the death rate for American infants increased for the first time in 20 years.”
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“rates of congenital syphilis — that is, syphilis infections acquired in the womb — have risen tenfold over the past decade.
Although a lot of different risk factors drive each of these trends, there’s an important one they have in common: bad — and worsening — health care access for mothers and babies.
In the US, the obstacles mothers face in accessing health care are too often insurmountable — and as this latest data shows, the consequences to American children are dire. Things might only get worse, some experts fear, as financial, political, and social pressures drive providers further from many of the places where they’re needed most.
“We only are hearing about more [obstetricians] leaving and more maternity wards closing,” said Tracey Wilkinson, a pediatrician who specializes in reproductive health issues at Indiana University’s medical school. “I am terrified about what the data is going to look like next year.””