Maternal Mortality Going Up, Not Down, in the U.S.

Thanks to Rebecca Clark for pointing to an article just published in Obstetrics and Gynecology showing that the maternal mortality rate is on the rise in the United States. The analysis was led by Marian MacDorman from the Maryland Population Center at the University of Maryland. Now, you might think that these data would come directly from the U.S. Centers for Disease Control, but no, cuts in funding at both the federal and state levels have made data collection a bit iffy. This should be a huge embarrassment for the world's richest country, as the authors themselves note. More embarrassing--and tragic--is the finding that the number and rate of women dying from pregnancy-related causes is going up. 

Clearly at a time when the World Health Organization reports that 157 of 183 countries studied had decreases in maternal mortality between 2000 and 2013, the U.S. maternal mortality rate is moving in the wrong direction. Among 31 Organization for Economic Cooperation and Development countries reporting maternal mortality data, the United States would rank 30th, ahead of only Mexico.

They look in detail at two populous states--California and Texas--and find that the maternal mortality rate has been going down in California and up in Texas. The paper is mainly about the calculation of rates and not about underlying causes of the changes, but the authors point out that California has deliberately stepped up its efforts in reproductive health, whereas Texas has gone the other direction. Lack of prenatal care and unsafe abortions are two important causes of maternal mortality and many states have been going the wrong direction with respect to women's health. The maternal mortality data provide the sad evidence of the damage that this does.