Maternal Deaths in U.S. Higher than Previously Believed: Study

The maternal death rate in the United States, which some say has been seriously under reported for decades, appears to be much higher than commonly believed, according to the findings of a new study that indicates that rate of fatalities among pregnant women is comparable to what is seen in Ukraine and Iran. 

In the United States, maternal mortality has increased over the past 15 years and rates are worse than every other industrialized nation in the world, with the exception of Mexico, according to a study published online this week by the medical journal The BMJ.

The findings of the new study highlight the importance of the U.S. focusing on improving maternal health conditions.

Researchers from the Boston School of Public Health analyzed state death certificates for 48 states and the District of Columbia. Data was taken from the National Center for Health Statistics and the U.S. Centers for Disease Control and Prevention (CDC).

Overall, maternal death rates in the U.S. increased by nearly 27% from 2000 to 2014. This is an increase from 18.8 deaths per 100,000 live births to 23.8 deaths. The maternal death rates are for 48 states, excluding California and Texas. California was the only state in country that showed a decrease in maternal mortality rates. Texas doubled its maternal death rate from 2011 to 2012.

Maternal mortality is the death of a woman while pregnant, or within 42 days of when the pregnancy is ended. The cause must be related to or aggravated by pregnancy or management of the pregnancy.

The findings indicate the U.S. is far behind other industrialized nations. A total of 157 of 183 countries studied had decreases in maternal mortality rates during that time period. Among 31 industrialized countries, only Mexico’s maternal death rate was worse.

The data indicates the U.S. did not meet the United Nations Millennium Development Goal of reducing maternal mortality rates by 75% by 2015.

The study also suggests the U.S. has been significantly under reporting the maternal mortality rate for decades. The last maternal mortality rate published in 2007 indicated a rate of 12.7 per 100,000 live births. Truer estimates indicate the maternal mortality rate of 21.3 per 100,000 live births in 2007. This is 68% higher than what was reported.

Researchers say the under estimation is because of delays in some states to adopt the  pregnancy question on the standard death certificate. The question was added in 2003, but only four states revised their death certificates that year.

In many developing countries the main cause of maternal mortality linked to delivery complications. However, the primary cause for mothers in the U.S. is underlying health conditions, such as high blood pressure, diabetes, and cardiovascular disease, which cause complications during pregnancy and delivery.

Researchers emphasized a need to refocus efforts in the U.S. to prevent maternal deaths and improve maternity care. They call the new findings, which put our maternal death rates in line with countries with lower quality healthcare, an embarrassment and a national risk. More than 4 million U.S. women give birth each year, placing many women at risk if the issue is not addressed.