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Negative trend

Why American women are increasingly dying in childbirth — especially black women

By WITW Staff on August 9, 2016

More American women are dying in childbirth than in any other developed country in the world, and more African American women are dying than any other ethnic group, according to research on the changing maternal mortality rates in the country. After decades of a declining maternal death rate, from about 607 deaths per 100,000 births in 1915 to about seven deaths per 100,000 births in 1987, the trend reversed beginning in 1987 and has continued rising ever since. The increase is now thought to be caused by the increase in chronic diseases in America, including heart disease, hypertension, obesity, and diabetes that can lead women to die in the delivery room.

“We’ve seen a big bump in cardiovascular disease and chronic disease contributing to maternal deaths,” Dr. William Callaghan, chief of maternal and infant health at the CDC, told Vox. “Underlying heart disease is common, diabetes is common. We now have a group of women bringing with them into pregnancy their entire health history.”

Common triggers for maternal mortality elsewhere, including hemorrhaging and infections, have not been part of the growing problem in the U.S. And age, though it has increased, has not had much effect on the mortality rate either.

Within the population of American women, black women are more likely to die from pregnancy complications than other ethnic groups, partly because they are less likely to begin prenatal care early and partly because they are more likely to have the pre-existing conditions that put them at high risk. Beyond that, though, doctors say it’s a complicated mix of “access to issues, differences in care based on geography, differences in health status” that lead to the disparity.

“It’s the thing that wakes us up in the middle of the night as we try to understand it,” said Callaghan.

Read the full story at Vox.


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