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New research shows that most maternal deaths in the US occur after birth

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(NEW YORK) – A new study analyzing maternal mortality rates has found that nearly two-thirds of maternal deaths in the U.S. occur up to a year after a woman gives birth.

The finding is part of a broader Commonwealth Fund study that analyzed maternal mortality among 14 developed countries and concluded that maternal mortality in the U.S. still far exceeds that in other high-income countries.

Researchers used data from the US Centers for Disease Control and Prevention (CDC) and the Organization for Economic Co-operation and Development (OECD). They found that 22 women die per 100,000 live births in the United States, compared to 0-14 maternal deaths per 100,000 live births in other countries. Sixty-five percent of deaths occurred after childbirth.

“This is unacceptably high. We know that almost 80% of deaths are preventable with the right treatment and care for women,” Munira Z. Gunja, lead author of the study and senior researcher at the Commonwealth Fund’s International Health Policy Program, told ABC. News.

“In the U.S., we’re really leaving women behind and not making sure we provide them with the right care so they can give birth safely,” she said.

The Commonwealth Fund analyzed data from the United States, Australia, Canada, Chile, France, Germany, Japan, Korea, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom.

In the United States, 22% of maternal deaths occurred during pregnancy, most often due to heart disease and stroke. About 13% of all deaths occurred on the day of delivery.

After delivery, 12% of deaths occurred in the first week after delivery, with high blood pressure, severe bleeding and infections being the most common causes. Twenty-three percent of deaths occurred up to 42 days after birth. Late deaths, which accounted for 30% of all deaths, occurred up to one year after birth and were often associated with cardiomyopathy.

Black mothers experience the highest mortality rate in the US. According to the report, 49.5 black women die per 100,000 live births.

The study found that the United States is the only country without a universal health care system. About eight million women are uninsured, and Black women are disproportionately affected, Gunta said.

“We know there are many steps the U.S. can take to truly reduce or eliminate maternal mortality. Other countries have managed to achieve this; the US could do the same,” Gunja said, later adding that understanding the timing of deaths is very important when it comes to maternal care so that barriers to care can be identified to ensure that women are goes well after giving birth.

Looking at maternal care provided in other countries, the US is the only country that does not guarantee at least one home visit by a midwife or nurse within a week of delivery, despite evidence that home visits are associated with better mental health and better breastfeeding outcomes. and lower healthcare costs.

Data shows that in most high-income countries, the number of obstetrician-gynecologists far exceeds the number of obstetricians. The US, Canada and Korea were the only countries where the number of midwives exceeded the number of midwives, with the lowest total provider pool, with 16 midwives and 13 midwives per 1,000 live births.

Gunja said expanding obstetric care and diversifying the workforce are critical to reducing mortality rates in the United States, especially among Black women.

“Having a midwife … who comes to your home, provides care, really builds a relationship with you, is a reliable source and is someone who is racially or ethnically similar to you also appears to play a major role in building of trust,” Gunja said. “Midwives can really be a reliable source of care for patients that we don’t always get when we go to our obstetrician.”

The study found that increasing the workforce of midwives and midwives, expanded maternal care coverage, guaranteed paid maternity leave and postpartum home visits could help reduce the alarming rates of maternal mortality in the US.

The Commonwealth Fund study comes just four weeks after the CDC released its annual report on maternal mortality in the US, which found that maternal mortality declined in 2022 after three years of continued increases. While this decline is a step in the right direction, Gunja says there is still a lot of work to be done.

“We know that most of these deaths are preventable, and we know that many other countries have managed to achieve close to zero or zero deaths,” Gunja said.

“Start actually implementing policies, and not just at the state level but at the federal level, so that we can ensure that every woman, not just women who have the right employer or women who live in the right state, have the right to support to take care of themselves before pregnancy, during and after pregnancy,” she said.

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