Reducing Maternal Mortality

New York Times March 5, 2019

​Reducing Maternal MortalityA new law to help states investigate deaths from childbirth complications is a start, but experts say what is really needed is reducing C-section rates.
By Emily Kumler Kaplan

Women in the United States face a far greater risk of dying from childbirth complications than in many other wealthy countries.

Now the federal government has taken a step toward addressing the problem with the Preventing Maternal Deaths Act, signed in December, which will provide federal grants to states to investigate the deaths of women who die within a year of being pregnant.
A report released by the Commonwealth Fund in December that looked at 11 high-income countries found that American women have the greatest risk — 14 deaths per 100,000 births — of dying from pregnancy complications. The Centers for Disease Control and Prevention reports an even higher rate, 18 per 100,000.
Whereas other countries have worked to reduce the risk of maternal mortality in recent decades, including Sweden, where the death rate is 4 per 100,000 births, and England, at 9 deaths in 100,000 births, death rates in America have more than doubled in the last 20 years. The report also concluded that African-American women face similar rates of death to those of women delivering in developing countries, with rates of 40 per 100,000, according to the C.D.C.

Although cardiovascular problems account for the highest percentage of maternal deaths, complications linked to surgical deliveries are among the biggest factors. One in three American mothers delivers her baby via cesarean section, a rate that has increased more than 500 percent since the 1970s. While C-sections can often be lifesaving for both mother and baby, the surgery involved also carries serious risks.
“Caesarean sections are effective in saving maternal and infant lives, but only when they are required for medically indicated reasons,” a 2015 report from the World Health Organization said. The report found that C-section rates higher than 10 percent were not associated with reductions in maternal and newborn deaths.

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