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With Maternal Mortality Rates on the Rise, OB Risk Must be a Priority: Article Excerpt

April 1, 2021
April 1, 2021

Global Maternal Mortality Rates are Grim—And the US is Not Excluded

Dying in childbirth is often assumed to be a thing of the past—we now live in an age where we have an understanding of nutrition and infection and access to clean water, modern medicine, and antibiotics. The reality is, death rates in childbirth did drop significantly by the end of the 20th century, and have continued to do so globally. According to UN inter-agency estimates, the global maternal mortality rate declined by 44 percent between 1990 and 2015 (UNICEF, 2018).

However, the statistics are still grim and the lives of the women facing the risk of dying a pregnancy-related death are reason enough to demand that we do better. Every day over 800 women die due to a complication in pregnancy or childbirth, and most of these deaths could be prevented. And while 88 percent of these deaths occur in sub-Sahara Africa and South Asia, maternal mortality is not only a problem for developing regions (UNICEF, 2018).

More than 700 American women die annually as a result of pregnancy or delivery complications (CDC Foundation, 2018). This is the highest maternal mortality rate of any high resource country, and along with Afghanistan and Sudan it is one of three countries in the world where the rate is rising instead of falling (Council on Patient Safety in Women’s Health Care, 2018). Further, the CDC Foundation reports that of these maternal deaths, a significant racial disparity has been revealed: “Non-Hispanic black women experience maternal deaths at a rate three to four times that of non-Hispanic white women” (2018).

The following graph exposes this devastating reality by comparing US rates to those of other industrialized countries (Martin & Montagne, 2017):

Causes of Pregnancy-Related Deaths

The World Health Organization (WHO) reports that most complications develop during pregnancy and are preventable or treatable. With hemorrhage as the leading cause of maternal mortality globally (UNICEF, 2018), WHO cites five major complications that account for nearly 75 percent of all maternal deaths (WHO, 2018):

  • Severe bleeding (mostly bleeding after childbirth)
  • Infections (usually after childbirth)
  • High blood pressure during pregnancy (pre-eclampsia and eclampsia)
  • Complications from delivery
  • Unsafe abortion

In a recent CDC Foundation study conducted by US maternal mortality review committees (MMRC), experts assessed pregnancy-related deaths from nine state-based MMRCs. The study reports, “Nearly 50% of all pregnancy-related deaths were caused by hemorrhage, cardiovascular and coronary conditions, cardiomyopathy, or infection. The leading underlying causes of death varied by race. Preeclampsia and eclampsia, and embolism were leading underlying causes of death among non-Hispanic black women” (2018). The leading causes of pregnancy-related deaths in the US are demonstrated in the following chart (CDC Foundation, 2018):

The Article also includes:

  • Who is Responsible for Prevention?
  • Innovative Agencies are Already Making a Difference
  • Make a Difference in Your Organization—Ensure Staff Competency to Save Lives

References

CDC Foundation. (2018). Report from nine maternal mortality review committees: Building U.S. capacity to review and prevent maternal deaths. Retrieved from https://www.cdcfoundation.org/sites/default/files/files/ReportFromNineMMRCs.pdf 

Martin, N., Montagne, R. (2017). The last person you’d expect to die in childbirth. ProPublica. NPR. Retrieved from https://www.propublica.org/article/die-in-childbirth-maternal-death-rate-health-care-system

UNICEF. (2018). Maternal mortality fell by almost half between 1990 and 2015. Retrieved from https://data.unicef.org/topic/maternal-health/maternal-mortality/

World Health Organization (WHO). (2018). Maternal mortality fact sheet. Retrieved from http://www.who.int/news-room/fact-sheets/detail/maternal-mortality

Download the article here.