When I give my talk “Free Delivery: the impact of a policy to improve access to maternity services in Ghana“, I generally start out by making the case that the difference between the maternal mortality rates in developed and developing countries is one of the most unjust statistics in all of global health – which I believe to be true. There are several orders of magnitude differences between the lifetime risks of deaths from a maternal death between the poorest and the richest countries in the world.

That is not to say, however, that such deaths do not occur in developed countries. Here in the United States, despite having one of the most advanced health care systems in all of the world (notice I did not say best) roughly 400 women die each year from pregnancy related conditions. That last statistic, which I have not confirmed myself, came from this deeply personal account of the death of a woman – Galit Schiller – here in the United States in 2007.

The story points to some of the challenges to lowering maternal mortality in a place like the United States – and elsewhere as well. The woman appeared to have had a normal delivery, was released on schedule from the hospital, and even celebrated the birth of her new baby with her family before dying quite suddenly from delayed bleeding. It is hard to say what should have been done differently in this case. Perhaps we will never be able to fully lower it to zero.

But the article also suggested something I did not know before – that the rate of maternal mortality has actually doubled in the United States from 1990 to 2005. I’m curious to learn more as to why this might be happening. Any suggestions?

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2 Responses to “America is not immune to maternal mortality”

  1. Kim Dionne says:

    increase in availability and uptake of cesarean sections?

    when I was pregnant in 2006, my first OB/GYN asked if I wanted to "schedule" the delivery. I looked at her puzzingly. she said that she could guarantee she would deliver if we scheduled a c-section, but that if I wanted to deliver naturally that I might deliver with someone who was on call instead.

    all of this is just to say that what used to be an important intervention occurring under emergent circumstances is now an "option" on the delivery menu.

    my hunch is that c-sections aren't the only intervention that is more widely available/prescribed during this period.

  2. Jack says:

    That is what blowing my mind these days. I don't know what is going on. When we will be free from all this

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