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Risk of death related to pregnancy and childbirth more than doubled between 1999 and 2019 in the US, new study finds
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- Authors
- Laura Fleszar, Allison Bryant Mantha, Catherine O. Johnson, Greg Roth
- Published
- Aug 18 2023
- Word count
- 644 words
The abstract from the study: https://jamanetwork.com/journals/jama/article-abstract/2806661
This is quite an alarming conclusion and one you don’t expect to read about “the richest and most free country on earth”. I hope they or other researchers follow up with a study about the why. I could make some educated guesses but sometimes the answers surprise you. I’m assuming it’s things like healthcare access, income inequality, systemic racism (numbers rose more among Black and Indigenous populations, though somewhat surprisingly deaths rose more in white populations than Hispanic or Asian & Pacific Islander - but only slightly).
Between 1999 and 2019, observed median state MMRs (maternal mortality ratios) increased from:
Math in parentheses is my own addition.
I do find it quite surprising that the white population had such a markedly higher rate of change between 1999 and 2019, I wouldn't expect that just from systematic injustices. Purely speculating, but I do wonder how much of this relates to the internet and proliferation of certain mom groups, if any at all. The whole report is sad and alarming, but the major hike for indigenous populations is disconcerting all its own. Not to mention the finding that, year over year, the Black population had the highest MMRs. I appreciate this work and hope it is a springboard for other works to investigate these injustices.
Thanks for laying that out (abstracts should really use bullet points more!). The added parentheses really highlight how alarming the rise is in the Indigenous populations.
That’s a good thought about white “crunchy” mums. I’m not sure it would be enough on its own but certainly could be a factor.
I'm betting money on C sections more so than crunchy. So much of hospital birth is geared towards prepping for a C section, even if you go in for natural childbirth. And doing so makes natural childbirth harder.
I see so many people scheduling C sections "for convienience." And it's kinda abhorrent having watched the process. It's major abdominal surgery, and increases death risk dramatically.
The c section rate in America is almost exactly the same as in Australia and we don’t see nearly the MMR as america here
America's problems are exacerbated by a shitty healthcare system. There's no getting around that.
Thinking more about it, it's probably a combo of both. Access to C-Sections saves lives, because it's the best option if natural childbirth is too risky (my firstborn survived because of it). So inequal access to C-sections means areas with poorer healthcare will have higher MMR and IMR. However, presuming no problems with mom or child, a c-section is definitely riskier than natural childbirth. Obesity also exacerbates both.
So for the US, I'd say its a volatile combo of poverty, obesity, and a crappy healthcare system that exacerbates both.
The big issue in my own personal experience is that insurance companies have been able to dictate access to care through pregnancy to save money. My wife was denied ultrasound after the 2nd trimester, which resulted in us finding out our baby was breech a week after our due date (and after her membrane was stripped). It was truly awful and only happened because insurance companies have decided you don't need an ultrasound at that stage of the pregnancy. Medical professionals should be making these decisions based on science. Not agencies dedicated to make money at the expense of our comfort, health and lives.
We are lucky that she didn't go into labor at any point, she could have died after hours of labor and an eventual c section anyway.
I don’t entirely disagree. But I think it’s inadvisable to just say it’s down to the c-section rate without expanding as you have here, as that puts people off from getting c-sections when they’re needed.
There is certainly something systemic going on, and factors working together to exacerbate the problem - everything brought up in this thread is also true of other places, but few other places have all of the factors together or perhaps not as severe. We have to acknowledge the multi factorial nature of the problem in order to fix it
This data just screams “demographic driven”. The study authors seem more concerned with the racial disparity than the increase. It’d be nice to see the full paper (paywall), but my guess is that wealthy and healthy people are having fewer children, so the at risk population makes up a bigger portion of the stats.
I wish this was in ~health instead. Things like this are really important for men to read about too!
I agree. I have moved it over.
Thank you!
You are right and it should be moved. Hopefully someone will help with that.
@cfabbro can you help please?