US: As heated debate heats up around abortion and healthcare access challenges, women in the United States face another battle: the rising risk of pregnancy-related death. The US has the highest maternal mortality rate of all high-income countries, with 22 deaths per 100,000 live births, according to an analysis published by the Commonwealth Fund in June. It based this assessment on data from the U.S. Centers for Disease Control and Prevention (CDC) as well as the Organization for Economic Co-operation and Development (OECD), of which the U.S. is a member. Some studies suggest that the high rate of U.S. maternal mortality may be due to specific shortcomings in the country’s healthcare system, including shortfalls that particularly impact women from minority groups. So what does the U.S. maternal mortality crisis look like? Is there a way forward? And will abortion restrictions make it worse?
What is the maternal mortality rate?
The maternal mortality rate refers to a woman’s death during pregnancy, childbirth, or the “postpartum” period due to complications after childbirth or miscarriage or after the termination of a pregnancy. These deaths can be caused by conditions such as excessive bleeding or seizures, but are related to or aggravated by pregnancy.
The U.S. count includes deaths within a year of childbirth or termination of pregnancy. Overall, 817 American women died of maternal-related causes in the U.S. in 2022. The country’s maternal mortality ratio that year was 22 deaths per 100,000 live births.
However, this rate varies by ethnicity. Black women are more than twice as likely to experience a pregnancy-related death than the country’s average. For every 100,000 live births among black women in 2022, about 50 women died within a year of childbirth or termination.
What causes a high maternal mortality rate in the U.S.?
Generally, some of the major complications associated with maternal deaths are “obstetric” or directly linked to pregnancy, such as excessive bleeding, placental abruptions in the birth canal, and seizures.
However, the type of risks facing pregnant women in the US appears to be changing. “Over the last two decades, we’ve seen a shift away from more traditional obstetric risk for death,” said Alison Gemmill, assistant professor in the Department of Population, Family and Reproductive Health at John Hopkins University in the US. “What we’re seeing now is that the majority of maternal deaths have some sort of underlying cardiovascular condition associated with them,” she added. Additionally, a CDC report found that some of the leading causes of maternal deaths between 2017 and 2019 were mental health and cardiovascular conditions (in addition to excessive bleeding). According to KS Joseph, professor in the Department of Obstetrics and Gynecology at the University of British Columbia in Canada, who studies maternal mortality worldwide, high-risk pregnancies from the start are also becoming more common. Part of this can be attributed to assisted reproductive technologies such as in vitro fertilization (IVF), which help women with fertility problems related to factors such as age or pre-existing health conditions to conceive.
