With so many young women I personally know having babies this year, I read with both anger and dismay Amnesty International’s damning report about pregnancy and childbirth care in the United States.
Released last Friday, the report, aptly titled “Deadly Delivery,” notes that deaths from pregnancy and childbirth in the United States have doubled in the past 20 years (from 6.6 per 100,000 live births in 1987 to 13.3 deaths per 100,000 live births in 2006).
That’s two to three women dying daily in the United States from pregnancy-related complications.
Some of that increase may be due to better reporting, but it’s more likely that the figures may actually understate the problem, for, as the Amnesty International report points out, there are no federal requirements to report maternal deaths.
American women are now at greater risk of dying from pregnancy-related causes than women in 40 other countries — five times greater than Greek women, for example, and four times greater than German women.
And another 1.7 million American women — a third of all women who become pregnant in the United States — experience some kind of pregnancy-related complication that adversely affects their health. Severe pregnancy-related complications (known as “near misses” because the woman comes close to death) have increased 25 percent since 1998.
Yet, as the Amnesty International report notes, the United States spends $86 billion annually on hospitalization related to pregnancy and childbirth — more than on any other area of medicine.
According to the Centers for Disease Control and Prevention (CDC), about half of all maternal deaths in the U.S. are preventable. Pregnant women and new mothers are dying because of “systemic failures” in our current health system, the Amnesty International report says. Those failures include non-existent or inadequate health care coverage (13 million American women, or one in five of reproductive age, have no health insurance), financial and physical barriers to accessing care (including a lack of physicians in rural areas), and an overuse of risky interventions, such as inducing labor and delivering via cesarean section.
African-American women are almost four times as likely as white women to die from pregnancy-related causes, according to the report.
Minnesota scores better than most states
There’s some good news for Minnesota women in the report’s appendix. We’re one of only five states that met the Healthy People 2010 goal (set in 1998) of reducing maternal deaths to 4.3 per 100,000 live births. Our current maternal mortality ratio is 3.7.
Still, 13.9 percent of Minnesota women receive delayed or no prenatal care. And for women of color, that percentage jumps to 27.9.
Behind the statistics
Interspersed among the appalling statistics in the Amnesty International report are truly heartbreaking stories of individual women who died or nearly died as a result of inadequate pre-natal or post-natal care. Here’s just one of those stories:
In 2007, Valerie Scythes, a 35-year-old teacher in a New Jersey elementary school, died after giving birth to a healthy baby, Isabella Rose. The cause of death was a blood clot (embolism). She had had a scheduled c-section and an ovarian cyst was removed at the same time. Despite her heightened risk of developing a blood clot, because of her age, weight and surgery, she received no preventative care. She was not provided with compression stockings or a blood-thinning drug and staff failed to ensure that she walked around as soon as possible – she had been in bed more than a day following her c-section when she died. Valerie Scythes’ attorney told Amnesty International, “I would like to see a national standard of care implemented, similar to what they have in place in England.”…
In an unrelated and tragic coincidence, Valerie Scythes’ close friend and teacher at the same elementary school, Melissa Farah, died following a c-section at the same hospital two weeks later. The cause of her death was shock as a result of hemorrhage. A hospital spokesman stated: “Our treatment protocols seem to be well in line with or consistent with what I’ll call appropriate treatment care.”