The US has a much higher maternal mortality rate than other similarly wealthy countries, and extraordinary inequality between white and black Americans, according to a new letter released by the US government. Commonwealth Fund.
The US outlier status persisted even as maternal mortality rates have improved in the post-pandemic era, both in the US and globally.
“We can always be happy if we’re moving in the right direction, that’s for sure,” says Munira Z Gunja, senior researcher at the Commonwealth Fund’s International Program on Health Policy and Practice Innovation. “But we still have a way to go.”
The Commonwealth Fund report compares the U.S. to 12 wealthy countries based on data from the Centers for Disease Control and Prevention (CDC) and the Organization for Economic Co-operation and Development, known as the OECD, a group of developed democracies. Although OECD data is considered the gold standard for international comparison, researchers say there may be differences in how countries collect data.
Researchers found that by 2022, 22.3 out of every 100,000 American women would die during pregnancy or within a year of giving birth. That’s a slight improvement from 2021, when American women died at a rate of 32.9 per 100,000.
Yet alarming disparities remain, especially between white and black mothers. White mothers in America died at a rate of 19 per 100,000 in 2022. Black mothers, by contrast, died at a rate of 49.5 per 100,000, or about 2.5 times the rate of white Americans.
Nearly every demographic group of American mothers is dying at a higher rate than all mothers in comparable countries. Norway, for example, has not documented any maternal deaths. The United Kingdom, that one thorough investigation in each death, counted 5.5 maternal deaths per 100,000.
Notably, most deaths among American mothers — more than 80% — are preventable, according to CDC data cited in the Commonwealth report.
“Any obstetrician could tell you about patients who are close to death, and those people don’t do these surveys,” said Dr. Erika Werner, chair of obstetrics and gynecology at Tufts Medical Center in Boston, Massachusetts, who was not involved in the study. was involved.
“Usually there is a missed opportunity – something we could have done before they got pregnant, during pregnancy or postpartum that could have prevented this morbidity,” which is what doctors call an illness or injury.
Gunja attributes the outlier rate in the US to the outlier policy. The US does not offer universal healthcare or paid maternity leave. Every equal nation offers both.
Switzerland offers the least maternity leave outside the US – and still mandates 14 weeks of leave for new mothers. Norway offers 86 weeks paid. Approximately in the middle is Great Britain, which has 39 weeks of leave.
“We are going back to pre-pandemic levels, which is a good thing, but we also know that we can implement many policies to eliminate the number of deaths,” Gunja said. “Access to postpartum care and maternal care in general should not depend on where (people) live or who their employer is,” she said, referring to U.S. policies that tie health insurance to employment.
Outside researchers said the brief highlights the importance of comparing the US, and its uniquely private and difficult-to-access health care system, with universal health care systems elsewhere. About 26 million Americans don’t have health insurance.
“At best, postpartum people have two visits after delivery, and that is when they are at the highest risk for maternal mortality,” says Werner. “And many of them lose insurance weeks (or) months after delivery.”
The report comes as the U.S. Supreme Court is expected to rule on whether states can ban emergency abortions to save a woman’s health — part of a conservative effort to impose a near-total abortion ban.
The 2022 data represents just six months after the fall of Roe v Wade, the Supreme Court ruling that once established a constitutional right to abortion. Since its fall, at least seventeen states have severely restricted or banned abortion.
“Maternal mortality is extremely important to monitor,” said Ariana Thompson-Lastad, research faculty at the Osher Center for Integrative Health at the University of California, San Francisco, who was not involved in the Commonwealth Fund study.
Although, she added, “not dying is a very low base for what we want to accomplish with parents of babies in the United States, and especially with Black and Indigenous parents in the United States.”