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Jonathan Lewis

Jonathan Lewis

The Surprisingly High Rate of Maternal Deaths in America

Posted: 01/27/11 11:05 AM ET

Whenever I read about "maternal mortality rates," I wince. How about the truth for a change? Mother death rate per newborns? Percentage of moms dead at birth of new babies? Number of orphans created at birth?

Here in America, 17 pregnant women die for every 100,000 births. In Australia and Sweden, by contrast, there are only five maternal deaths for every 100,000 births. The figure is six in Ireland, seven in Germany and Canada, and eight in Norway, according to a recent study in the medical journal The Lancet.

To be competitive about life-saving, in Slovakia the rate is six maternal deaths per 100,000 childbirths. Slovakia spends $565.00 per capita on health care; Americans spend over $6,000.00 per person on health, as reported in "The Value of Nothing" by Raj Patel.

For minority populations, Patel reports, the numbers are getting worse, not better. "If the African American population rate in the United States were a separate country, [it] would be ranked below Uzbekistan, which has a maternal mortality rate of 24 per 100,000, and where the average income per person is $840.00 per year."

But there is some good news to celebrate. "The number of women dying due to complications during pregnancy and childbirth has decreased by 34 percent from an estimated 546,000 in 1990 to 358,000 in 2008," according the World Health Organization. Not good enough, but let's be happy for the 188,000 female lives saved.

"Every day, about 1000 women died due to these complications in 2008. Out of the 1,000, 570 lived in sub-Saharan Africa, 300 in South Asia and five in high-income countries. The risk of a woman in a developing country dying from a pregnancy-related cause during her lifetime is about 36 times higher compared to a woman living in a developed country," the report adds.

In the United Kingdom (with its single payer, universal, socialized health care system), the rate is eight women per 100,000 births. Some politicians believe that America has the best health care system in the world. Is that true?

As Nicholas Kristof and Sheryl Wudunn point out in "Half the Sky," "the issue is almost never covered [in the media]" even though the maternal death rate equals about two jumbo jets crashing each day, all passengers and crew killed. Because the numbers are reported to him with greater frequency and immediacy, in my opinion Speaker Boehner would probably know more about his own golf score than the health score of his Ohio constituents.

I wonder if the Speaker has ever played at one of Italy's centuries-old golf courses. If so, he might learn that Italy is the safest place in the world to give birth. Only one woman in 100,000 dies in childbirth. For pregnant women, Italy -- a single-payer, nationalized, universal health care system -- is indeed "la dolce vita."

 
 
 
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HUFFPOST COMMUNITY MODERATOR
SageFire
I like Obamacare, like Single Payer best
07:07 PM on 02/02/2011
I think these statistics need to be much more granular. What was actually happening when the mother's lost their lives? Twenty years ago I was involved in a organization called the American Gentle Birthing Association. We were a collection of MDs, Midwives, NDs and parents. Our belief is that women should have complete control over the birth of her child. If a woman is more comfortable in a medical setting that is exactly where she should be because she will feel safe and relaxed allowing her body to do what it knows how to do. In my case, I gave birth to my two daughters in a tub of warm clean water at home, attended by a highly qualified OB/GYN. My son had been born via C-Section after induced labor gone wrong and I was willing to do anything I needed to in order to not repeat that experience. Being in water allowed me unconstrained movement to get my babies easily through my pelvis and additionally relaxed my muscles. They were each lifted above the water and handed to me, they each looked around as if to say "Oh, there you all are!" then they both settled into a very quiet calm state of rest. Most importantly, I was where I wanted to be and felt safe.
08:08 AM on 02/01/2011
A group of women who were outraged by the maternal mortality rate in the US started the Safe Motherhood quilt, a project with quilt pieces telling each woman's story. Many of the stories are of medical mistakes. Many women die because of the use of strong labor-starting drugs killing women and babies. It's not women not caring about themselves or their babies and doing nothing. It's women who don't care about their babies and allowing doctors to do anything to them without speaking up and saying "NO". Look up the Safe Motherhood quilt online and read the stories--more than 200--and you'll get a glimse at what is killing our mothers. It's appalling that this is allowed to continue without as much as a cry from the American public--there should be an roar!
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alongst
too often denied to speak
10:57 AM on 02/03/2011
I've lost count how many times a woman in labor was dropped off at our ER by a midwife who couldn't handle the sudden complications of a home birth- usually they just dump them at the front door and drive off to avoid prosecution.
11:43 AM on 01/31/2011
The comments stating things like "pregnancy is extremely dangerous" & childbirth is a big risk" are attitudes that allow medical interference into the experience & allow extreme measures to be done on healthy, normal pregnancies. More & more accepted medical practices such as numerous sonograms & other invasive prenatal tests & the PET & other common hospital procedures are now being exposed as what are really what are extremely dangerous & risky to the fetus & the mother. The question posed as to how many women used midwives & homebirth is a good one-but I wasn't sure if it was asked in a positive or negative way.
There is an ever increasing population of American women who are taking birth back into their own hands because they either have had a bad OB/GYN -hospital birth or are becoming more aware of what really turns a normal pregnancy & birth into an "extremely dangerous & risky" birth.
An amazing thing happens when medical interference is removed from the equation. Parents become far more aware & educated in what is normal & much less likely to be sucked into a highly profitable hospital birth. In fact the movement back to homebirth is becoming so strong that there are constant legal battles against midwives & homebirth by the medical profession who is threatened by it. Funny thing though-the legal profession ALWAYS manages to continue making bank off the birth industry, on either side of the delivery table. As does the insurance industry.
11:05 AM on 01/31/2011
Maybe it's because of the extremely high interference by the medical profession into what is supposed to be a natural human experience causing this. Of course, the article didn't state what the causes of death were, merely mentioned that black women in particular are the most highly affected.
It certainly opens up several trains of thought as to why black women ARE more likely to die, as opposed to an other "minority" in the US. Is it monetary? Is it ignorance? Is it abuse of the medicaid system "providers" who only do so much according to the pay scale? If it's just monetary-then most people on substandard insurance or without insurance are all going to be affected by the level of care dictated by that.
WAY more information needs to be told about this -the article really did nothing but state data.
And WAY more people who are having babies-need to educate themselves to prevent BAD MEDICINE.
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10:31 AM on 01/31/2011
There are a lot of women who choose not to sign up for state programs and the like and follow any kind of maternal care or prenatal care. They just don't care.
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09:56 AM on 01/31/2011
A lot of women in this country who are pregnant are stupid. They act stupidly, they don't take care of themselves or their babies to be, etc. How many of these maternal deaths are due to women strung out on drugs and other things?
 
You can't fix stupidity.
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HUFFPOST SUPER USER
thinkingwomanmillstone
My life is microbiodegradable.
09:26 PM on 02/01/2011
My daughter's classmate died a few years ago during childbirth...she was 24 years old, had pre natal care and gave birth at a renowned hospital. Her husband, family and friends were shocked and devastated because no one expects this in the US. They thought like you...it's someone else's problem. It's really easy to write it off as indifference or worse by the mom...then you don't have to think about it and no changes need to be made. People who are stupid should still not have to die from it when it is obviously preventable. Our governor just cut out prenatal services for the underpriveleged....real family values.
11:39 PM on 01/30/2011
There have been several recent stories of Catholic hospitals excommunicating nuns or withdrawing their affiliation with hospitals that save the mother's life by aborting a life-threatening pregnancy. I would like to know how many of these maternal deaths occur at Catholic-run hospitals, and how many of these are because life-saving procedures for the mother were withheld to try to save the fetus, or extremely risky pregnancies were continued because of the hospitals' religious guidelines instead of medical guidelines.

I'd also like to see a break-down of how many of these dead mothers got any sort of prenatal care, and why those that didn't--didn't.

We should be ashamed of these kinds of numbers.
05:47 PM on 02/01/2011
Interestingly Ireland with 6 deaths, has a very Catholic ethos in its Hospitals and most were run by the catholic church until very recently.
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HUFFPOST SUPER USER
sunflwer1975
Just a girl!!!
10:21 PM on 01/30/2011
what is not always mentioned or noted as maternal death related is homicide.
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HUFFPOST SUPER USER
CommonWealth-SinglePayer
Shop As Usual... And Avoid Panic Buying
02:57 PM on 01/30/2011
"Some politicians believe that America has the best health care system in the world. Is that true?"
Yes and No.
Yes, the USA has some of the best technology and brain trusts to lead that innovative thinking.
No, the delivery of that amazing technology to the US public is pathetic at best.
And I understand why Politicians think they have great HC, they have HC Insurance provided by the US government for life!
So therefore, why not extend the Single-Payer Health Care, tax supported Insurance that seems to work for the US Gov., Military, Elderly and Poor and let the rest of the people have some?
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HUFFPOST BLOGGER
Jonathan Lewis
Founder/Host, iOnPoverty
10:00 PM on 01/30/2011
Actually, what I originally wrote (before the editors at Huffington Post changed it), was: "When Republican House Speaker John Boehner tells you America has 'the best healthcare system in the world,' he is either profoundly uninformed or just plain untruthful­." Your assessment is more nuanced than my comment, but I would add that there is something unfair and just plain wacky about a curative healthcare that spends so much and leaves so many moms and babies at risk. Other countries seem to understand that the delivery of healthcare ought not to be ideologically based and certainly not income based.
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HUFFPOST SUPER USER
CommonWealth-SinglePayer
Shop As Usual... And Avoid Panic Buying
01:25 AM on 01/31/2011
How can you live the American Dream when it could be sidelined by any Health Care issue. In countries that have Single-Payer HC, the people can save money for retirement or investment, knowing they can NEVER go bankrupt due to a medical condition.
02:11 AM on 01/30/2011
I'd like to see the stats for these countries on access and use of midwives in births.
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sabelmouse
my micro bio is emty
07:56 AM on 01/31/2011
holland ' which wasn't mentioned has a great record and still the highest number of home births. my own experience of giving birth as well as the pre and post natal care was great.
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french queen13
my beloved is mine and I am his
07:48 PM on 01/31/2011
I don't know the stats, but I know the governments here in Australia try to stop midwives attending births by making registration difficult. It's very medicalised. The great majority of births are in hospital.
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alongst
too often denied to speak
01:45 PM on 01/29/2011
Maternity care is free to all in this country- if they apply for it. Many choose not to and the first time they see a doctor is the day they deliver. Most of these countries named don't have the drug problems, illegal aliens and ghettos we have. It's amazing how many women present to Labor and Delivery while still on crack or meth.
Our county has a free maternity clinic. The doctors were tired of having to take care of women in delivery who had no prenatal care and therefore causing harm to mother and child. So they started a clinic and staffed it themselves by volunteering. The result. A few women showed up. Their reason for not going?
"I couldn't get a ride". So the OB docs teamed up and bought a van to pick them up. A few more showed up. "I didn't like the time the van came by". So don't blame the "Greedy docs" who paid for this out of their own pockets- blame the person responsible- the patients.
Almost all pregnant women qualify for Medicaid- a single payer, yet it is still a disaster- and you want everyone on it ?
Too many Csections ? Thank the lawyers. 90% of OB docs practicing more than ten years have been sued. Are 90% of them bad? Nope. But rather than wait and see, they will now do a csection at the first sign of fetal distress to prevent some lawyer in court saying they didn't act
11:51 AM on 01/30/2011
No thank Doctors and the practice of Pit to distress "New practices reduce childbirth risks"
"Hospitals are conceiving new programs to make childbirth safer, amid mounting evidence that overuse of labor-inducing drugs for preterm deliveries and other common practices in the delivery room are endangering both mothers and infants.

Read more: http://www.post-gazette.com/pg/06193/705248-114.stm#ixzz1CXOdcE2F
More about this practice..
" Pit to Distress"
Friday July 10, 2009
There is a lot of talk going on about a phenomena called "Pit to Distress." Basically this means that an obstetrician or midwife orders pitocin to be given, typically during an induction, at a rate or in such a way that it is likely to cause the baby to go into fetal distress and require a cesarean.........http://pregnancy.about.com/b/2009/07/10/pit-to-distress.htm

The doctor not the lawyer done it
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HUFFPOST SUPER USER
sunflwer1975
Just a girl!!!
10:26 PM on 01/30/2011
what????? what planet are you from?? NOT all women can get on Medicaid. If you make more than minimum wage you don't qualify. Most all married women don't qualify either. You need to get your head out of the sand if you think our problems are so unique that there is no solution...
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alongst
too often denied to speak
10:52 AM on 02/03/2011
Thus the free clinic we doctors started for ones who could not get Medicaid. Or were you not reading what I wrote ?
03:40 AM on 01/28/2011
If there was anything to go "socialist" about - it is maternity care. Care should be "free at the point of delivery" in the Affordable Care Act. The one time when you want people turning up, is during pregnancy and labor. Not just because you will prevent maternal and neonatal deaths but also because it is going to save you in a fortune in subsequent health care bills for mother and baby.

Mothers get gynecology if they are neglected in labor. Preterm babies (15% in US) develop many chronic diseases over the rest of their lifetimes. Even paying for a C-section for 60-70% of women (cf China and Brazil) would be cost-effective. It is not clear if it would save lives.
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Welib
Peace on Earth!
12:45 PM on 01/27/2011
Some politicians believe that America has the best health care system in the world. Is that true?
 
No, it's not true.  We have doctors in this country that are profit driven and they grouse about taking medicare patients.  I know lots of them do and the majority doesn't make a big deal out of it, but there are lots that would prefer not to touch poor people.
 
Doctors come from all around the world to practice in the USA because really, it's the last vestige of capitalism where they can still charge exhorbitant fees and get away with it.  For some reason we find that acceptable because half of the population believes doctors will close up shop if the US goes universal health care.  Where the heck else are they going to go since the rest of the world pretty much has universal too?  Until we get universal or single payer, they will continue to gouge us and they won't apologize for it.   They think they are entitled just as the GOP think they're entitled to taxpayer money and use it like it's their own personal ATM.
 
Universal health care systems negotiate for lower and more reasonable drug costs around the world.  The USA is the only place they can charge breath-takingly inflated prices for drugs made right here.  They gouge Americans to the tune of hundreds of times more for drugs than other countries pay.  I live in Canada and I pay 1/6th of the cost my sister pays for the same medication in Florida.  That's not the best example because it only reflects 6 times the cost when for most drugs they market them up 500% or more. 
 
What is government for if not to work FOR the people.  This is how government is viewed and how it works in all other western countries.  Their governments make sure their people are looked after, health care cradle to grave and their people are healthy and which makes their country's healthy.
 
In the USA states remove people, 240 thousand last week in AZ from medicare.  They refused to pay for people's transplants and say it's optional.  If their life was on the line I bet it wouldn't be optional.
 
The right screams death panels but the only REAL death panels we've seen are Republican death panels cutting our people's health care off and instead like Jan Brewer asking for money for more tax cuts for the wealthy.  Why do the wealthy matter more than the rest of us?
 
08:46 AM on 01/29/2011
Excellent remarks, Welib. You are correct in your analysis that having a government that works for the people creates a stronger country. Looking in from the outside, it appears that the government in the USA works for corporate profit, and the aim of each successive government is to stay in power, rather than good governance. I would rather measure the strength of a country by the quality of life of the average citizen than by GDP and the profitability of its corporations.
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Welib
Peace on Earth!
05:21 PM on 01/29/2011
Thank you Reelcanajun.  I live in Canada too, married to one that I swear has ice in his veins. 

I completely agree with you.  I always thought that government was supposed to work for the people but then we look at the USA and Africa and see that it doesn't always work that way.  The only thing that bothers me about living in Canada is the conservative government that appears to want to tear that health care down as much as possible.  But the conservatives here are Conservative Lite, compared to the US conservatives.  Although Harper and his gang of right wing corporatists make me think of the US and that's frightening.  I see them little by little attacking and trying to dismantle health care.  Canadians will never let it happen.   I tell my American family, you want make a Canadian mad, try taking away their health care.  Hahahaha.  Great country and I love it.  Wonderful, wonderful people.  From the bottom of my heart, this country is home for me now forever.  I go home all the time and I love it but this country is just so laid back, tolerant, inclusive. 

Republicans do not know how to run the US.  They run it into the ground every time they get in.  They couldn't run a lemonade stand without bankrupting it.
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HUFFPOST BLOGGER
Jonathan Lewis
Founder/Host, iOnPoverty
11:22 AM on 01/29/2011
Before the editors at Huffington Post changed it, the original statement in my blog was: "When Republican House Speaker John Boehner tells you America has 'the best healthcare system in the world,' he is either profoundly uninformed or just plain untruthful." .
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Welib
Peace on Earth!
08:03 PM on 01/30/2011
Ha, you KNOW the answer to that one now don't you.
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HUFFPOST SUPER USER
Paperless Tiger
12:28 PM on 01/27/2011
Childbirth is a big risk for a woman. It can be life threatening and it is guaranteed to cause unpredictable physical problems, even a woman's vision can be impaired by hormonal changes due to childbearing. Anti-abortion advocates are willfully ignorant of these risks in their obsession with the fetus. They want the State to force women to give birth. If a woman chooses not to risk her life for an unwanted pregnancy, they call her a "baby killer."
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10:30 AM on 01/31/2011
it's pretty easy to avoid pregnancy in the first place.
12:16 PM on 01/27/2011
Pregnancy is extremely dangerous and medical care in this country is, given its cost, apparently a luxury item.

Real health care reform could have changed all that but our politicians (of BOTH parties) care more about appeasing health insurance companies.