America lags in preventing maternal deaths and complications

Saturday March 3, 2018

This isn’t the 1800s. This isn’t some third world country. Then why are so many American women dying – or suffering near-death complications – from childbirth?

The United States has the highest rate of maternal deaths in the industrialized world. The Centers for Disease Control says near-fatal experiences and lasting injuries from giving birth are actually increasing. How is this happening in America? Why are we going backward?

We have the highest rate of childbirth complications – and it’s getting worse

The CDC reports that 700 to 900 women in the U.S. die each year from pregnancy or childbirth. Another 50,000 endure traumatic and life-threatening complications such as hemorrhage, stroke, blood clots, cardiac arrest and sepsis. These medical emergencies often result in catastrophic harm such as brain damage, paralysis, organ failure, sterility, in addition to harm to their babies.

The rate of serious complications more than doubled from 1999 to 2014, according the CDC. American women are five times more likely to undergo an emergency hysterectomy than their counterparts in England or Sweden. They are three times more likely than British women to need a breathing tube during or after childbirth. And so on.

This is America. We should be on the cutting edge of maternity care.

Despite world class medical institutions, the U.S. is experiencing third world levels of maternity problems. Why are we lagging, despite having one of the most expensive health care systems? Researchers cannot point to any single factor for the high mortality rate and the increasing maternal morbidity (related complications):

  • American women are giving birth at a later age, which increases the odds of diabetes, hypertension and other pregnancy-related conditions. But this trend is true in other countries too.
  • Our system focuses on prenatal care, but essentially cuts mothers loose once the baby is born. Insurance companies pressure to have women discharged as soon as possibleafter childbirth, often with little follow-up.
  • A comprehensive study of nursing programs revealed that providers do not spend enough time educating expectant mothers and new moms about the risks or warning signs of complications.
  • Limited access to health insurance and quality health care plays a role. Pre-existing conditions that complicate pregnancy disproportionately affect women in rural areas, women of color, and women in impoverished neighborhoods. Many of these medical conditions go undiagnosed.
  • Many women encounter “delay and denial,” the tendency of doctors to downplay the concerns of pregnant moms and new moms when in fact they have life-threatening conditions.
  • American women are far more likely to have cesarean births or induced labor. These procedures are often unnecessary and can contribute to dangerous complications. In 1960, only 5 percent of U.S. births were by C-section. Today nearly one-third of all U.S. deliveries are C-sections, twice the rate of European countries.

Maternal complications come at a terrible cost

The annual cost of medical intervention for hemorrhage, pre-eclampsia and other complications of pregnancy and child birth is in the billions of dollars. The psychological impact of a hysterectomy, chronic infections, organ damage, depression and other aftermath is immeasurable. Mothers and their newborns suffer, along with their partners and other children.

Sometimes there is simply a combination of factors working against mothers. But sometimes there is actionable medical negligence contributing to undiagnosed ailments, problems in delivery, or post-partum calamities. A malpractice attorney can determine if there are grounds to sue for damages.

Sources: Centers For Disease Control, NPR and ProPublica

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