US maternal death rate soars by 27 percent since 2000

Kate Randall

The maternal death rate in the United States is rising sharply, even as it has declined in other industrialized nations. Between 2000 and 2014, under the Bush and Obama administrations, the nation’s maternal death rate rose by 27 percent and is likely to rise even further.

This shocking statistic comes from research published online August 8 in the journal Obstetrics & Gynecology. While researchers noted that reporting methods changed during this time period, lead researcher Marian MacDorman of the University of Maryland said that about 20 percentage points of the 27 percent increase reflected a “real” rise in women’s deaths.

These figures present a scathing indictment of the social order that prevails in America, the world’s wealthiest country, whose government proclaims itself to be the globe’s leading democracy. They are just one manifestation of the human toll taken by the vast and all-pervasive inequality and mass poverty that dominates American society.

Along with other indicators of growing social distress and societal retrogression, such figures give the lie to US President Barack Obama’s statements earlier this year that the US economy is the “envy of the world” and that “America is pretty darn great right now.”

In other industrialized countries maternal death rates have fallen sharply since 1990, according to the Institute for Health Metrics and Evaluation (IHME). In South Korea, for example, the rate of women dying in childbirth fell from 20.7 deaths per 100,000 live births to 12 today; it dropped in Germany from 18 to 6.5.

Since 1987, the first year the Centers for Disease Control and Prevention (CDC) began collecting data, the maternal mortality rate in the US has more than doubled. About 700 women die out of 4 million annual live births.

In addition to maternal deaths, more than 23,000 infants died in their first year of life in 2014, or about six out of every 1,000 born, according to the CDC. Twenty-five other industrialized nations do better at keeping their smallest and most vulnerable residents alive.

The latest research tracking maternal deaths follows reports on declines related to the health of the vast majority of Americans in other areas, including rising mortality rates due to drug addiction and suicide, and a burgeoning gap between the life expectancy of the bottom rung of income earners compared to those at the top.

A major cause of increasing maternal deaths in the US, according to theObstetrics and Gynecology researchers, is the rising toll of chronic diseases among women. Three decades ago, most maternal deaths could be attributed to hemorrhages (women bleeding to death), pregnancy-induced hypertension disorders, infections in the delivery room and complications from anesthesia.

Pregnant women in the US are now much more likely to die due to preexisting conditions such as heart disease or diabetes, which are more prevalent among low-income women. Cardiovascular disease and cardiomyopathy (related to weakened heart muscle tissue) account for more than a quarter of all pregnancy-related deaths, as reported by Vox. Cardiovascular conditions accounted for less than 10 percent of maternal deaths 30 years ago.

A new report from the CDC shows that in 2014 more than 50 percent of women were either overweight or obese before becoming pregnant. Being overweight or obese in pregnancy is in line with the overall obesity epidemic in the US. While researchers found these conditions prevalent among all socioeconomic layers, obesity is strongly associated with poverty, lack of access to nutritious foods and life stress.

Obese women in pre-pregnancy were more likely to be older than 40, black, American Indian or Alaska Native, according to the CDC. They were also less likely to have attained a college degree and more reliant on Medicaid to pay for their delivery. Being overweight or obese is directly correlated with high-blood pressure and diabetes among pregnant women, conditions that can lead to pre-term deliveries and cesarean sections.

While the risk of death from pregnancy complications rises with age, experts say that age alone does not explain why maternal deaths are rising in the US. Nicholas Kassebaum of the IHME told Vox that pregnancy risks increase “exponentially past the age of 35,” but that “the number of women who have delayed pregnancy in the US has not gone up more” than in other industrialized countries.

Black women are two to three times more likely to die as a result of pregnancy and childbirth than white women. Government studies have shown that black women are less likely to receive prenatal care in the first trimester and more likely to suffer from preexisting conditions than white women. Researchers have found this to be true regardless of age, education level or socioeconomic status.

According to the CDC, the difference in maternal death rates for white and black women is currently one of the most severe disparities in the US health care system. This is mostly likely associated with a lack of access to health care services as well and the affordability and quality of medical care black women receive.

A 2014 “Shadow Report for the UN Committee on the Elimination of Racial Discrimination” found: “In Chickasaw County, Mississippi, the MMR [maternal mortality rate] for women of color (595 per 100,000 live births) is higher than rates in countries of Sub-Saharan Africa, including Kenya (400) and Rwanda (320).”

The disproportionate maternal death rate among African-Americans in the US is one of the most extreme expressions of the social divide between rich and poor, and the racial inequities accompanying it. According to the 2000 US Census, Chickasaw County (cited above) had a per capita income of $13,279. Twenty percent of the population lived below the official poverty line, including 24 percent of those under age 18 and 22 percent of those age 65 and above.

A second study in the same issue of Obstetrics & Gynecology also found that deaths of US women during pregnancy or soon thereafter often have nothing to do with childbirth or pregnancy complications. The study tracked maternal deaths in Illinois between 2002 and 2011 and found that more than one-third were the result of car accidents, substance abuse, suicides and homicides—all indications of the pervasive violence in US society.

The rising US maternal death rate must be viewed aside other signs of social inequality affecting the health and lives of working families in 21st century America:

• A drug-addicted baby is born every 19 minutes, subject to grueling detoxification and facing the potential for life-long health complications.
• In 2014, there were 47,055 drug overdose deaths, 61 percent of them from opioids.
• The mortality rate for white Americans aged 45-54 with no more than a high school education increased by 134 deaths for 100,000 people from 1999 to 2014.
• The life expectancy gap between the richest 1 percent of the population and the poorest 1 percent in the US is 14.6 years for men and 10.1 years for women.

The Obama administration’s Affordable Care Act, which is enriching the for-profit health care industry, is aimed at forcing workers and their families to self-ration health care, which will inevitably result in more premature deaths and suffering.

These glaring indicators of the social reality—combined with low wages, poverty, debt and other manifestations of economic insecurity for the vast majority of the population—find no mention in the 2016 presidential campaigns of the two big-business parties. Both Hillary Clinton and Donald Trump champion the interests of the ruling elite in the form of increased military spending, corporate tax breaks and cuts to social programs.

Rising maternal deaths and infant mortality and declining life expectancy can be countered only by putting an end to medicine for profit and establishing free, high-quality, state-run health care for all as part of a struggle to reorganize society on a socialist basis.