The maternal mortality rate is an important marker of how well the health care system of a country is doing. In third world or war torn countries the rate can be as high as 1 death in every 7 pregnancies. Countries including Afghanistan, Niger, Chad, and Guinea-Bissau have the highest risk of maternal death during or following pregnancy. The largest factor in reducing maternal mortality rate is access to reliable health care and so it is no surprise that in countries where this is not available maternal mortality is high. Other factors affecting maternal mortality include age (too young and too old), income, and unsafe abortions. Many of us would consider the countries with the highest maternal mortality rate to be very different than the United States, a first world country with access to cutting edge medicine, optimal healthcare, and proper nutrition. However, the United States shares something with these countries, it is 1 of only 8 countries to have their maternal mortality rate increase from 2003 to 2013. To explore this increase in more detail, a group of researchers working out of Maryland published results showing that Maternal mortality rates increased from 18.8 per 100,000 births to 23.8 per 100,000 births between 2000 and 2014.
This increase in mortality rate has been consistent across the US for almost every state since the year 2000. The only state to show a decrease in maternal mortality rate over that period of time was California, a state in which there was a pregnancy mortality related review in 2006 that implemented a number of changes to the way in which complications such as preeclampsia and hemorrhage were treated. These changes seemed to have made a significant contribution to reducing the mortality rate or pregnant mothers. Unfortunately, every other state showed an across the board increase in maternal mortality rate over the 14-year period. This increase was most apparent in Texas where the rate doubled over the 14-year period from 17.4 per 100,000 to 35.8 per 100,000, that is a shocking increase. What’s more striking is that the change in mortality was relatively flat for 10 years until 2010-2011 where it suddenly doubled to 33 per 100,000. From 2011 to 2015 there were a number of changes to women’s health services in Texas that could account for this jump. These included the closing of a number of women’s health clinics and this may contribute to this increase. There was also a law limiting abortions in the state and causing the closure of a number of clinics, see here. This law has since been overturned. Other causes could include women having children at an older age or becoming pregnancy while dealing with complications such as obesity and high blood pressure. Still, a doubling of the mortality rate in a region without war, famine, or disease is remarkable and unlikely to be caused solely by the changes to the health care for women. The researchers suggest that by looking into differences in mortality rates among different ethnicities they may be able to better understand what is going on. The likely cause is limited access to appropriate health care, poor health insurance, and rural communities all combining with the socioeconomic problems across different ethnicities. The United States government needs to figure out what is happening and why, this is not an okay problem to have in any country, never mind the US.
Image credit: Flickr TipsTimesAdmin