Amnesty International released its report on maternal mortality in the U.S. last week, calling the situation "scandalous" and "disgraceful." It’s an excellent report, well worth reading. Here are a few highlights:
- Hospitalization related to pregnancy and childbirth costs the U.S. some $86 billion a year; the highest hospitalization costs of any area of medicine.
- Despite this, during 2004 and 2005, 68,433 women nearly died in childbirth in the U.S.
- More than a third of all women who give birth in the U.S. – 1.7 million women each year – experience some type of complication that has an adverse effect on their health.
Amnesty International said: "The USA spends more than any other country on health care, and more on maternal health than any other type of hospital care. Despite this, women in the USA have a higher risk of dying of pregnancy-related complications than those in 40 other countries. For example, the likelihood of a woman dying in childbirth in the USA is five times greater than in Greece, four times greater than in Germany, and three times greater than in Spain."
In early February, California Watch reported that the California maternal mortality rate had risen to nearly 17 per 100,000 live births. Although the number of deaths is relatively small, it’s more dangerous to give birth in California than it is in Kuwait or Bosnia.
In some places, and among some populations, it’s much higher: In the state of Georgia the rate is 20.5 per 100,000; in Washington, D.C., it's 34.9; and in New York City, the ratio for black women is 83.6 per 100,000 live births, according to the Amnesty International report.
It’s worth pointing out that we already know how to improve these numbers: Better care. There’s a long tradition of medical practitioners going into an area with the most abysmal numbers and getting results that beat the national average.
For example, the DC Developing Families Center, which serves predominantly African American women in the poorest section of Washington D.C., has maternal and infant mortality rates that stand at zero. It offers a midwife-centered form of care. The Amnesty International report points out that the low number of midwives in the U.S. may be contributing to the problem:
In many countries midwives or family practitioners are the usual maternal care providers for low-risk pregnancies, and specialist doctors – obstetricians – are asked to step in only in high-risk cases and in cases where complications develop unexpectedly. In contrast, in the USA, although 83 percent of women have low-risk pregnancies, the vast majority receive care from obstetricians and only 8 percent are attended in childbirth by a midwife. … An individual woman’s ability to actively participate in her care is hampered by a lack of information about care options and the failure to involve women in decision-making regarding their own health care.
The complete report can be found here.
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