U.S. joins poor nations as recipient of programs to save pregnant women’s lives

In 2011, the U.S. pharmaceutical giant Merck & Co. launched an international program aimed at decreasing the number of women who die or develop severe complications related to pregnancy and childbirth.

Until now, the 10-year, $500 million “Merck for Mothers” initiative has focused on developing countries with large impoverished populations, such as India, Uganda, Brazil and Zambia.

On Tuesday, however, Merck announced that it was expanding the initiative into the United States. And with good reason. The U.S. death rate from pregnancy- and childbirth-related causes is scandalously high — and increasing. It climbed from 7.2 deaths per 100,000 live births in 1987 to 17.8 deaths per 100,000 live births in 2009, according to the U.S. Centers for Disease Control and Prevention.

As I’ve noted here before, that means two to three women die every day in the United States from pregnancy-related complications.

In addition, as a damning 2010 report from Amnesty International pointed out, 1.7 million American women — one-third of all women who become pregnant in the U.S. — experience some kind of pregnancy-related complication that adversely affects their health.

Minnesota and its cities are not among the Merck program’s recipients. That’s probably because the state has a comparatively low maternal death rate. In 2010, Minnesota had the sixth-lowest rate among all 50 states: 5.0 maternal deaths per 100,000 live births.

Deaths coded differently now

Part of the rise in the U.S. maternal death statistic may be explained by changes in the way deaths are coded, notes the CDC. In recent years, many states have added a pregnancy checkbox to their death certificates, thus increasing the likelihood that pregnancy-related deaths will be identified.

The rate of maternal deaths in 2009 was also affected by that year’s H1N1 (swine flu) pandemic. The risk of dying from the H1N1 virus was significantly higher for pregnant women than for the general U.S. population.

Still, in 2010, American women were at a greater risk of dying during pregnancy and childbirth than women in 46 other countries.

Preventable causes

“The tragedy is that many of these deaths are actually preventable,” stated Kenneth C. Frazier, Merck’s chairman and CEO, in a statement released Tuesday.

According to the World Health Organization, the leading global causes of maternal deaths are hemorrhaging, infection, eclampsia (very high blood pressure that triggers seizures), obstructed labor and unsafe abortions.

“While these are the main causes of maternal death, unavailable, inaccessible, unaffordable, or poor quality care is fundamentally responsible,” WHO adds.

Here in the U.S., chronic health conditions — such as heart disease, diabetes and high blood pressure (conditions often associated with obesity) — are also major factors in pregnancy-related deaths, according to the CDC.

Last Sunday, at a meeting of the American Heart Association, researchers reported that most pregnancy-related deaths in California are caused by heart disease. The authors of that study also said that at least one-third of those deaths could be prevented.

“Women who give birth are usually young and in good health,” stated Afshan B. Hameed, M.D., the study’s lead researcher and associate professor of clinical cardiology, obstetrics and gynecology at the University of California, Irvine, in a press release. “So heart disease shouldn’t be the leading cause of pregnancy-related deaths, but it is.”

Several states, cities included

The “Merck for Mothers” program has committed $6 million to programs in several U.S. states and cities.

Projects include working with community-based clinics in Baltimore to improve prenatal care for women with chronic health conditions and running a home-visiting program (“Safe Start MOMobile”) in Philadelphia that gives high-risk pregnant women health education and support.

You can read more about “Merck for Mothers” programs and projects at the initiative’s website.