Dying to Give Birth: A Public Health Nightmare

Early Intervention Can Stop Maternal Deaths

Early Intervention Can Stop Maternal Deaths

Women giving birth or within forty-two days of ending a pregnancy from any cause other than accidents or inflicted injuries define “maternal death.” The United Nations Population Fund estimates there are nearly 300,000 maternal deaths annually. Numbers and rates of maternal mortality are dropping globally, but shockingly, the numbers and rate in the U.S. are rising.

The World Health Organization (November 2015) reports:

* Every day, approximately 830 women die from preventable causes related to pregnancy and childbirth.

* Ninety-nine percent of all maternal deaths occur in developing countries.

* Maternal mortality is higher for young adolescents, women living in rural areas, and women living in poor communities.

* Skilled care before, during, and after childbirth can save the lives of women and newborn babies.

* Between 1990 and 2015, maternal mortality worldwide dropped by about 44 percent.

Modern obstetric medicine, public health advancements, access to medical care, social welfare interventions, and education were landmarks in the twentieth-century battle against maternal deaths. Epidemiologists have the numbers to prove it.

Rising Rates of Maternal Deaths

In the 1930s, rates of maternal deaths dropped in advanced nations to about one in one hundred live births. The numbers of South Korean women dying in childbirth have fallen in the past half-century from twenty-one to twelve per 100,000, and German women dying dropped from eighteen to fewer than seven in 2015. In the United States, 607 maternal deaths were recorded in 1915, but seven per 100,000 in 1987.

America is one of eight countries, including Afghanistan and South Sudan, with increasing numbers of maternal deaths since 1987: from seven in 1987 to 15.9 in 2012, according to the Centers for Disease Control and Prevention (CDC) Pregnancy Mortality Surveillance System. Poverty and race play a baffling role in US maternal deaths. Black women are two to three times more likely to die in childbirth from a health condition than whites, regardless of age, education, and living conditions.

Some of the suspects for the increase in the United States include:

* Late-age pregnancies are on the rise.

* More women are fatter and suffering from chronic diseases including cardiovascular disease, hypertension, diabetes, and other health problems in greater numbers despite the nationwide emphasis on no smoking, no drinking, eating healthy, and exercise.

Interventions

Efforts by Dr. Julius Richmond, US surgeon general in the 1970s, to improve access of pregnant women to prenatal care through a network of maternal and child health centers in poor urban and rural locations contributed to some improvements.

Interventions recommended today include having state-based maternal death review boards collect better data, advocate for early interventions, outsource much of their work to university medical and public health departments, use private companies to design intervention plans, community education and outreach, and redirect budget allocations that will more effectively cut the rates of maternal deaths in target communities. One in three maternal deaths is preventable, so early intervention will save lives and resources.

Dr. Goldmeier was a Research and Teaching Fellow at Harvard University, where he received his Doctorate in Education. He is a former consultant to the US Surgeon General on federally funded Maternal and Child Health programs. Currently, he teaches international university students and serves as a business analyst and development consultant for companies and nonprofit organizations. His new ebook on Amazon is Healthcare Insights: Better Care Better Business.

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