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A Major Problem in a Developed Country in 2022 in This Economy?

A Major Problem in a Developed Country in 2022 in This Economy?

Maternal Mortality in the USA 

By Emmett Pennington-Guthrie 

The United States has the highest maternal mortality rate of any developed country. [1] 

This is a serious issue stemming from multiple causes, made more troubling considering the number of maternal deaths has been increasing since 2000. [2] 

Many maternal deaths do not occur during childbirth; in fact, 52% of maternal deaths occur from one day to a year after giving birth. 17% of maternal deaths occur on the day of delivery, and only about a third of deaths occur during the birth itself. [3] 

Most of the deaths happening after the day of childbirth happen relatively soon after, with 19% of deaths being 1-6 days postpartum, 21% being 7-42 days postpartum, and 12% of deaths happening 43-365 days postpartum. [4] 

These deaths don’t occur equally, as African American women have maternal mortality rates three times higher than white women. [5] 

The racial disparities persist across age groups and education levels, as “among women with a college education or higher, black women have an over five times higher pregnancy-related mortality rate compared to white women.” [6] 

Even comparing college-educated Black women to high school-educated white women reveals Black women to have a mortality rate 1.6 times that of white women. [7] 

Particularly aggravating is the fact that most of these deaths are considered preventable. For instance, the “leading cause of pregnancy-related death among women overall” is cardiovascular conditions, showing that treating chronic conditions is especially important for reducing mortality levels. [8] 

In addition to chronic conditions, another factor in heightened maternal mortality is the increased usage of Caesarean sections, or C-sections, as well as other forms of over-interventions. C-section use in hospitals varies from 6% to 70%, compared with 12% to 22% in Sweden, for instance. [9] 

C-sections can cause avoidable harm to mothers and infants such as causing placenta accreta, which causes excessive bleeding for the mother after giving birth. [10] 

Additionally, there is a problem in the US involving skyrocketing healthcare costs fueled in part by the number of interventions done in hospitals, which not only makes birth more expensive for new mothers but also drives up costs for the hospitals themselves. 

What has not been touched on yet is the massive problem that is understaffing in hospitals, and the ongoing need for better staffing ratios to decrease maternal mortality rates. 

As previously reported by yours truly, healthcare outcomes are worsened when hospitals are understaffed, and OB-GYNs and midwives are currently in short supply– 15 and 12 providers per 1,000 births, respectively. [11] 

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According to estimates by the American Congress of Obstetricians and Gynecologists, “the U.S. will have between 6,000 and 8,800 fewer ob-gyns than needed by the year 2020 and a shortage of possibly 22,000 by the year 2050.” [12] 

Interestingly, studies have shown that the midwifery model of care is as good if not better at providing care than that of OB-GYNs in terms of patient outcomes and satisfaction, as well as being more efficient in terms of health system resources. [13] 

This finding on midwifery’s efficacy indicates that the current emphasis on OB-GYNs over midwifes may be mistaken and inefficient, especially given that most births in the US are considered low risk, meaning that OB-GYNs aren’t necessarily needed to provide care in most cases. [14] 

Finding ways to increase staffing levels in hospitals, especially of midwives, could be an effective way to combat maternal mortality. 

References 

  1. Tikkanen, R., Gunja, M.Z., FitzGerald, M., & Zephyrin, L. (2020, November 18). Maternal mortality and maternity care in the United States compared to 10 other developed countries. The Commonwealth Fund. https://www.commonwealthfund.org/publications/issue-briefs/2020/nov/maternal-mortality-maternity-care-us-compared-10-countries 
  1. Ibid. 
  1. Ibid. 
  1. Ibid. 
  1. Artiga, S., Pham, O., Orgera, K., Ranji, U. (2020, November 10). Racial disparities in maternal and infant health: An overview. KFF. https://www.kff.org/report-section/racial-disparities-in-maternal-and-infant-health-an-overview-issue-brief/ 
  1. Ibid. 
  1. Ibid. 
  1. Ibid. 
  1. Shaw, D., Guise, J.M., Shah, N., Gemzell-Danielsson, K., Joseph, KS., Levy, B., Wong, F.,Woodd, S., & Main, E.K. (2016). Drivers of maternity care in high-income 

countries: Can health systems support woman-centred care? The Lancet

388(10057), 2282-2295. https://doi.org/10.1016/s0140-6736(16)31527-6  

  1. Ibid. 
  1. Tikkanen, R., Gunja, M.Z., FitzGerald, M., & Zephyrin, L. (2020, November 18). Maternal mortality and maternity care in the United States compared to 10 other developed countries. The Commonwealth Fund. https://www.commonwealthfund.org/publications/issue-briefs/2020/nov/maternal-mortality-maternity-care-us-compared-10-countries 
  1. Ollove, M. (2016, August 15). A shortage in the nation’s maternal health care. PEW. https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2016/08/15/a-shortage-in-the-nations-maternal-health-care  
  1. Tikkanen, R., Gunja, M.Z., FitzGerald, M., & Zephyrin, L. (2020, November 18). Maternal mortality and maternity care in the United States compared to 10 other developed countries. The Commonwealth Fund. https://www.commonwealthfund.org/publications/issue-briefs/2020/nov/maternal-mortality-maternity-care-us-compared-10-countries 
  1. Ibid. 
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