Pregnancy Related Deaths Higher in US than any other Rich Country

The New York Times today published an article that fortunately has gotten a lot of attention. It details the tragedies of women and their babies dying because of pregnancy-related problems. To be sure, there is a reason why people have always said that "getting pregnant may be the most dangerous thing a woman can do," but maternal mortality rates have come down dramatically all over the world. Yet, here in the United States the rates are higher than in any other rich country, according to data compiled by the World Health Organization, and they have been going up, not down, according to the U.S. Centers for Disease Control and Prevention. Here's their graph of the trend:

The reason for the increase, and for the fact that the U.S. is higher than other rich countries seems to have a simple remedy--examine every such incident and figure out what went wrong and circulate that information so health practitioners won't keep making the same mistakes. You might think that everyone would want to do that, but sadly you would be wrong.

It wasn’t until 2003 that states started adding a pregnancy check box to death certificates, and some didn’t do so until the past two years. “Thiscreated a data mess where nobody could figure out what the national trends were,” she said. She described this as “a huge missed opportunity for intervention in conjunction with the Millennium Development Goal.” At the same time, “the National Center for Health Statistics, which is the government agency responsible for publishing maternal mortality data, completely stopped publishing it.” 

The only exception in the United States was California, where, in 2006, the Stanford University School of Medicine worked with the state to create the California Maternal Quality Care Collaborative. The initiative developed “quality improvement tool kits” that doctors and hospitals could download. They included detailed instructions about best practices for various preventable complications that can arise during or after pregnancy, like hemorrhaging and pre-eclampsia.

As a result of this initiative, between 2006 and 2013, California saw a 55 percent decrease in the maternal mortality rate, from 16.9 to 7.3 deaths for every 100,000 live births. During that same period, according to The Washington Post, the national rate increased — from an estimated 13.3 to 22 deaths in 100,000.

Next door, in Canada, the rate is 7 per 100,000, and in Switzerland it is 5, just to give you a sense of where the U.S. stands.