The Issues

RISING MATERNAL MORTALITY AND POOR HEALTH OUTCOMES

The rate of mothers dying in childbirth or due to pregnancy-related causes continues to climb in the U.S. even while it declines in industrialized countries.

What’s even more appalling is that more than 60% of maternal deaths in the U.S. are preventable and unnecessary.

Pregnancy related deaths in the U.S.

The figure above shows that the rate of maternal deaths quintupled in the last thirty years despite advances in maternal care.

WHY?

The reasons maternal death rates are on the rise in the U.S. include:

  • Poor access to healthcare
  • Discrimination and disrespect
  • Lack of information about family planning options
  • Healthcare provider shortages

Beacause of these barriers, the U.S. has the highest rate of maternal death out of every industrialized country.

 

It’s even worse for women of color. Maternal death for American Indian/Alaskan Native and non-Hispanic Black women is 3 to 4 times more likely to happen compared to white women.

But maternal mortality isn’t the only issue we care about. Keep reading to learn more about the issues facing women and families in the U.S.

PERINATAL DEPRESSION

Perinatal mood and anxiety disorders can appear during pregnancy, or days or even months after childbirth, and does not usually resolve without treatment.

It is estimated that 15-21% of pregnant women experience moderate to severe symptoms of depression or anxiety. Without appropriate intervention, poor maternal mental health can have long term and adverse implications for mother, child, and family.

We need legislation and programs to improve recognition, support, and treatment of perinatal and postpartum depression including comprehensive mental health services.

An estimated

%

of PREGNANT WOMEN EXPERIENCE DEPRESSION OR ANXIETY AFTER CHILDBIRTH

Healthcare disparities

Racial and ethnic persons of color suffer a disproportionately high burden of diseases and experience higher rates of mortality. Approximately 83,000 preventable deaths occur each year as a result of racial and ethnic health disparities, including high infant mortality rates. Over the last 30 years, persons of color, particularly African-American and Hispanic/Latina women, continue to experience worse health outcomes when compared to non-Hispanic/Latina white women.

Premature Birth

In 2015, 1 in 10 babies was born too early or premature in the U.S.

From 2007 to 2014 the rates were on a decline, but recently there has been a rise in premature births across the nation.

WHY?

A combination of factors influence rates of prematurity. Many of the same reasons such as poor access to care, inadequate prenatal care, maternal co-morbidities, and racism are responsible for these outcomes.

Geography plays a significant role, with southern states suffering one of the highest rates of premature births.

The figure above grades preterm birth rates by state, with the best ranked as A and worst ranked as F. The Premature Birth Report Card grades are assigned by comparing the 2015 preterm birth rate in a state or locality to the March of Dimes goal of 8.1 percent by 2020. The Report Card also provides county and race/ethnicity data to highlight areas of increased burden and elevated risks of prematurity.

Access to healthcare

There are major pockets of the US where individuals do not have access to needed maternity care services and/or do not have either Commercial or Medicaid insurance coverage.

The figure above shows which states have adopted Medicaid Expansion, giving more women access to care.

WHY?

There is a maternity care provider shortage.

High quality maternity care is essential for promoting maternal health and positive birth outcomes. Maternal mortality rates are three to four times higher for women who do not receive prenatal care, while access to early prenatal care has been shown to reduce rates of low birthweight.

Poor pregnancy outcomes can lead to a lifetime of health consequences for both mother and infant. For that reason, it is critically important that every opportunity be taken to extend insurance coverage to pregnant women. Ensuring access to prenatal care and the array of services provided is one of the best ways to promote healthy pregnancies and healthy babies.

 

The US does not mandate universal services for maternity care for all childbearing age women.

Shortages in rural areas are even greater and some families travel over 30 miles to reach a physician or midwife. Lack of access to quality care leads to poor outcomes like premature births, maternal and infant mortality, and racial disparities in care.

Further reading

Amnesty International. Deadly Delivery the Maternal Health Care Crisis in the USA: One Year Update
http://www.amnestyusa.org/sites/default/files/deadlydeliveryoneyear.pdf

CDC Maternal and Infant Health
https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pmss.html

CDC Premature Birth
https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.htm

March of Dimes Premature Birth Report Card
http://www.marchofdimes.org/mission/prematurity-reportcard.aspx

Institute for Women’s Policy Research
https://iwpr.org/publications/paid-parental-leave-in-the-united-states-what-the-data-tell-us-about-access-usage-and-economic-and-health-benefits/

Bureau of Labor Statistics
https://www.bls.gov/OES/current/oes291161.htm

Bureau of Labor Statistics
https://www.bls.gov/oes/current/oes291064.htm

Think Progress
https://thinkprogress.org/how-the-zero-weeks-of-paid-maternity-leave-in-the-u-s-compare-globally-a8ba7f36f85b#.ocxvqtpvt

ASTHO Issue Brief
http://www.astho.org/Programs/Health-Equity/Maternal-and-Infant-Disparities-Issue-Brief/

CDC: Health United States 2015: With Special Feature on Racial and Ethnic Health Disparities
https://www.cdc.gov/nchs/data/hus/hus15.pdf

MomsRising.org: Raising Our Voices For Maternal Health
https://s3.amazonaws.com/s3.momsrising.org/images/Maternal__Health_Justice_Birth_Story_Book_Feb_2018.pdf

SOCIETY FOR MATERNAL FETAL MEDICINE
http://www.choosingwisely.org/societies/society-for-maternal-fetal-medicine/

ACNM Talking Points
http://www.midwife.org/acnm/files/ccLibraryFiles/Filename/000000004024/HR4385TPs.pdf