For decades the disparities between women in the United States has led to maternal mortality rates that vary greatly by income, insurance type, race, ethnicity and geographic location. While rising rates of severe complications and death during pregnancy and childbirth underscored the shortcomings of the U.S. health system since 2000, the Covid-19 pandemic has exacerbated our failings at a rapid rate.
According to a new report published by the Commonwealth Fund, Maternal Mortality and Maternity Care in the U.S. Compared to 10 Other Developed Countries, among high-income countries, the United States has the highest maternal mortality rates. In fact, a woman giving birth in the U.S. is about 10 times more likely to die than a woman giving birth in New Zealand (17.4 and 1.7 deaths per 100,000 live births, respectively).
The international comparison looks at the U.S., Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the U.K., concluding that pregnancy and childbirth are more dangerous for American women than their 10 counterparts. Further, the study suggests health workforce shortages are current pain points that may be worsened by the coronavirus – further undermining an already faulty system.
But there is much to learn from our understanding of what makes the American health system – and women’s access to care – different from the countries of comparison. Given that the U.S. has the highest maternal mortality rate among developed countries suggests there are a number of contributing factors, and that the issues run deep throughout our system. Further, that we have deficiencies from beginning to end of the birthing process.
Here are the most important conclusions for consideration in America:
– U.S. women have the highest death rate from complications of pregnancy and childbirth. In 2018 there were 17 deaths per 100,000 live births – a maternal mortality rate that is more than double the rates of most other high-income countries. In comparison, the Netherlands, Norway and New Zealand experience three maternal deaths (or less) per 100,000 live births.
– 17% of maternal deaths in America occur on the day of delivery.
– A shocking 52% (more than half) of maternal deaths in the U.S. occur after birth. A period of time often referred to as the fourth trimester – usually ranging from one week to one year postpartum – is when a majority of postpartum deaths occur.
– In 2018, the death rate for Black mothers was more than two times that for white mothers. As Covid-19 has widened disparities through the pandemic’s disproportionate health and economic burdens on Black people, racial and ethnic gaps are not only likely to persist, but potentially deteriorate for Black mothers.
– The U.S. and Canada have the lowest overall supply of OB-GYNs and midwives, having only 12 and 15 providers per 1,000 live births, respectively. In contrast, the nine other countries in the study have a proportion two to six times greater.
– Midwives are in far lower supply in the U.S. than other high-income countries.