The U.S. ranks a shocking 60 out of 180 countries when it comes to maternity death rates, according to The Lancet, a weekly medical journal. America is one of only eight countries in the world to see an increase in its maternal mortality rate over the past decade; Greece, Afghanistan and several nations in Africa and South America round out the other seven. In 2013, 18.5 mothers died for every 100,000 births in the U.S—a total of nearly 800 deaths. Nationwide, black American women are four times as likely to die during childbirth than white women, according to Amnesty International.
As alarming as these figures are, Congress has been slow to act. U.S. Representative John Conyers (D-Mich) is sponsoring H.R. 4216: the Maternal Health Accountability Act of 2014 but the bill has not gotten a lot of political support. Conyers told AlterNet that the bill will require all states to mandate health professionals and facilities to report pregnancy-related deaths, investigate and develop case findings and summaries for each occurrence, establish review committees with ob-gyns, nurses, social workers, healthcare facility representatives and other relevant stakeholders to recommend prevention strategies, disseminate findings and recommendations, among other steps.
“This bill will help address this unacceptable racial disparity by helping to address a range of barriers to safe pregnancies ranging from health complications to financial needs,” said Conyers, whose district includes Detroit. “The bill will promote accountability and shared responsibility between states, the federal government, and healthcare providers to identify opportunities for improvement of care and means to educate health professionals, women and families about preventing pregnancy-related deaths and complications.”
According to govtrack.us, the bill has only 25 co-sponsors and a 1 percent chance of passing. There’s not much hope at the state level either; most states don’t even track pregnancy-related deaths.
Timoria McQueen, a mother who was diagnosed with PTSD after she gave birth four years ago, has been one of the most vocal supporters of Conyers’ bill.
She told AlterNet, “I have great healthcare. I could afford to have a surgeon come in from Cornell over the George Washington Bridge to New Jersey in 15 minutes to perform the procedure that saved my life. Every day I realize how lucky I was because I get the emails about people who’ve lost their family members or husbands who’ve lost their wives (during childbirth). Even healthcare professionals reach out to me and the most commom sentiment is that they cannot believe that this is happening in the United States.”
Kristen Rowe-Finkbeiner, executive director of MomsRising, a Washington D.C.-based advocacy group that lobbies congress on behalf of American mothers, told AlterNet that every mother in the U.S. should have the same shot at surviving childbirth as McQueen.
“This is critically important because it shouldn’t matter what hospital or situtation you end up gving birth in that determines if you live or die,” Rowe-Finkbeiner said. “In the United States of America, that’s the case right now because there aren’t standard practices for childbirth emergencies.”
In Detroit, a mostly African-American city, the maternal death rate is three times greater than the national average, according to the Kaiser Health News:
Experts attribute increased maternal death rates to uncontrolled chronic health conditions, which are more common in African-Americans, and to poverty that deprives low-income women of health insurance and access to health care. Detroit fits squarely within those perimeters: 83 percent of residents are black, and Detroit has more people living under the poverty line — 42 percent — than any major city in America,according to an analysis of U.S. Census data by the Annie E. Casey Foundation.
According to the St. Louis Post-Dispatch, there are a number of reasons why maternal deaths occur, though most are preventable:
Studies show that maternal deaths and severe complications can largely be prevented with changes in health behaviors and quality of care. Doctors say pregnancy has become increasingly risky for several reasons: the prevalence of obesity, Type 2 diabetes, hypertension and cardiovascular disease; more older women having children; advancements in fertility treatments resulting in twin births; and the high rate of C-sections.
“All of those things put together are causing what seemingly was a downward-going problem to tick back up,” said Dr. Michael Nelson, vice chairman of obstetrics at Washington University School of Medicine. “Even though the absolute risk of having a mortality from one complication is very low, many women have multiple conditions.”
The leading causes of pregnancy-related deaths are changing. When the Centers for Disease Control and Prevention began in 1987 taking a closer look at maternal deaths, hemorrhage was blamed for more than one in four. Now it’s diseases of the heart and blood vessels.
Deaths from stroke are also on the rise. A recent CDC study shows pregnancy-related strokes increased by 50 percent in 2006-2007, compared with 1994-1996.
Experts are calling for more research on how chronic conditions are best managed during pregnancy and how to identify and respond to complications.
For now, only more than half of U.S. states have protocols in place to record mortality deaths. This leaves experts with limited data on exactly why and how many mothers die during childbirth each year. McQueen says the passing of the Maternal Health Accountability Act will help answer these questions.
“People just want something tangible,” she said. “We keep reading these reports. The numbers are going up. Black women are dying at four times the rate of white women and people are asking what’s being done? What can we do? There’s something that we can do. We can ask Congress for help and that’s what I’m trying to do. To simply say, Can you please pass this bill that supports maternal health research so that we can find out why these disparities in birth deaths are happening.