U.S. Has Highest Maternity Death Rate of Any Wealthy Nation: Study

New research suggests women in the United States have the highest maternal death rate among the 10 other high-income nations in the world, raising questions and concerns about the quality of healthcare in the United States, and access to high cost treatments.

According to the Commonwealth Fund’s 2020 International Health Policy Survey, the maternal death rate in the U.S. was three times higher compared to the other countries studied, indicating that nearly 24 women in the U.S. die per 100,000 live births, and that rate triples for Black women. By comparison, in Norway, there were zero maternal deaths in 2019.

The findings suggest the quality of healthcare for women of childbearing age in the United States is lagging far behind every other high-income country.

For the study, researchers compared measures of health care access and outcomes for women of reproductive ages 18 to 49 in 11 high-income countries. Researchers focused on gaps in the U.S. health system for women and the policies in other nations that provide more equitable access and better health outcomes.

Women in the U.S. have the highest rate of avoidable or preventable deaths compared to the other 10 countries, according to the findings. Research indicates this is largely driven by the lack of access to healthcare overall and the high expenses women face when seeking healthcare.

The report also indicates women in the U.S. are more likely to have problems paying their medical bills, or to skip or delay needed care because of the high costs. It also notes women in the United States and Switzerland spend more out-of-pocket on health care than women in other countries.

Half of women of childbearing age in the U.S. reported skipping needed care because of high costs compared to 12% of women in the Netherlands. More than 10 million women in the U.S. still don’t have health insurance and those that do often pay high copays, coinsurance and deductibles.

Overall, women in the U.S. were more likely to report having at least one medical bill problem in the past year, having difficulty paying for medical care, being unable to pay a bill, spending a lot of time on paperwork or disputes related to medical bills, or having an insurer deny payment for a claim. Comparatively only one in 10 women reported having these problems in the UK.

Women in the U.S. also have the highest rates of multiple chronic conditions and the highest rate of mental health needs. In the US, one in five women reported having two or more chronic conditions compared to fewer than one in 10 women in Switzerland, Germany, Sweden and France.

The report notes women in the U.S. are also less like to have a regular doctor or place of care, which can help ensure good health outcomes. Nearly all women in the Netherlands and Norway reported having a regular doctor.

Additionally, the U.S. has high rates of c-sections and inadequate prenatal care, which can lead to worsened outcomes for women, the researchers found. Using primary and preventive health care, including cancer screenings and immunizations, can reduce early and unnecessary deaths.

This year, following the second consecutive increase in maternal death rates in the U.S., federal health officials launched a new campaign focused on encouraging doctors and medical providers to prioritize pregnancy and postpartum care and to listen to patient concerns. The program is aimed at reducing the risk of unnecessary maternal deaths and reducing the risk a doctor may fail to diagnose pregnancy-related complications or miss early warning signs that can lead to deadly outcomes.