Introduction
Despite being a highly developed country, the United States is severely lacking when it comes to maternal healthcare, especially when compared to similar high-income nations. The efficacy of maternal healthcare is usually characterized by maternal morbidity – which describes the short-term and long-term health issues that occur as a result of pregnancy or giving birth – and maternal mortality – which refers to the death of a woman from complications from pregnancy or childbirth. It’s also important to note that pregnancy or childbirth-related deaths can occur up to a year postpartum due to improper maternal healthcare although this time period can change depending on the study.
The Numbers
When compared to countries of a similar economic status, the United States lack of effective maternal healthcare is striking. According to data collected by the World Health Organization, which measures the maternal mortality ratio by deaths caused during or within 42 days after the termination of pregnancy, the average maternal mortality ratio for the United States is 23.8 deaths per 100,000 live births. While this may appear insignificant at first glance, the countries with the next highest maternal mortality rates are New Zealand with 13.6 deaths per 100,000 live births and South Korea with 11.8 maternal deaths per 100,000 live births. Furthermore, 84% of pregnancy-related deaths in the United States are preventable. These disparities are striking and indicate just how much more work is there to be done in the United States.
Racial Disparities
According to the World Health Organization, in 2020, the maternal mortality rate was 55.3 per 100,000 live births for Black women in the US compared to 19.1 per 100,000 live births for white women in the US. This rate increased to 69.9 deaths per 100,000 live births for Black women in the United States in 2021. It is thought that this vast disparity is caused by the cumulative stress of racism which can increase a Black woman’s biological age and by overt and implicit bias from healthcare providers.
The Causes
Listed below are just a few of the many causes for the maternal mortality crisis in the United States.
Heart Conditions
Over the past few years, the presence of cardiovascular disease has greatly increased in the United States. Cardiovascular conditions, such as heart disease and stroke, are some of the primary causes of maternal mortality. Cardiomyopathy is the main cause of maternal deaths up to a year after birth. Furthermore, Americans are increasingly affected by high blood pressure, which can lead to preeclampsia, a potentially deadly condition that develops during pregnancy and poses a risk to both the mother and the child.
Mental Health
Something that is often overlooked when it comes to pregnancy is postpartum depression (PPD). Women with PPD can often be overwhelmed by feelings of sadness and anxiety and may consider harming themself or their child if untreated, making suicide one of the leading causes of maternal mortality. It’s extremely important for healthcare providers and family members to observe the behavior of a mother after delivery to watch for signs of PPD and ensure that proper treatment is observed.
Lack of prenatal care
Another aspect of pregnancy that may often go overlooked is the importance of prenatal care. Typically, women should be going to an obstetrician before (if planned) and throughout their pregnancy to discuss important information and potential issues, such as medical histories and pre-existing health conditions. Healthcare providers will then provide a list of action steps as well as recommended prenatal vitamins/supplements that can improve the chances of a safe birth. Pregnant women should continue these visits throughout their pregnancy to receive physical exams, blood pressure checks, ultrasounds, and blood tests, to further ensure a safe delivery or identify any areas of concern.
Younger women, women with less education, and lower-income women often either overlook or don’t have proper access to prenatal care, which can greatly increase the maternal mortality rate.
Conclusion
Maternal mortality is an issue that has plagued the United States for decades and will continue to be a major issue if there continues to be a lack of reform. Education about reproductive health should be mandatory and widespread so that people are aware of potential pregnancy complications and prenatal care. Healthcare providers need to work to acknowledge their bias – implicit and overt – and change their practices to suit the needs of their patients. It is up to us to create this change in the present and resolve the maternal mortality crisis.
Very informative. Good job !!