by Birthright: A War Story | Updated on 12.3.18
US Women Today Are 50 Percent More Likely To Die Due To Pregnancy-Related Causes Compared With Their Mothers, Harvard Professor Says
By Fiza Pirani, The Atlanta Journal-Constitution
A new blog post from Harvard Medical School professor Neel Shah highlights America’s worsening problem
Women in the United States are more likely to die from childbirth or other pregnancy-related causes than other women in the developed world, according to the Atlanta-based Centers for Disease Control and Prevention.
In fact, while the international trend is in the opposite direction, the number of reported maternal deaths in the U.S. has steadily increased from 17 deaths per 100,000 pregnant women in 1990 to more than 26 deaths recorded per 100,000 pregnant women in 2015. The rate is the highest in the developed world, six times that of Finland.
Georgia’s own maternal death rate, once ranked the worst in the nation, shows no signs of improving.
A recent analysis from Harvard University further highlighted the country’s exacerbated problem.
“Compared with their own mothers, American women today are 50% more likely to die in childbirth,” Harvard Medical School obstetrics, gynecology and reproductive biology professor Neel Shah wrote in the Harvard Health Blog. “And the risk is consistently three to four times higher for black women than white women, irrespective of income or education.”
For every death, he said, worrisome pregnancy-related conditions such as high blood pressure or blood clotting can result in up to 100 severe injuries. Factor in inadequately treated physical or mental illnesses, the lack of paid parental leave policies or lack of social support and tens of thousands more women are at risk.
Overall, “very few deaths counted in maternal mortality statistics occur during childbirth,” Shah wrote. “Rather, four out of five of these deaths happen in the weeks and months before or after birth.”
“The association between mental illness and mortality is complicated because mental illness does not directly kill women, but rather serves as an underlying factor resulting in injury in the form of suicide, accidental deaths, and deaths due to homicide,” according to the Maternal Mortality Review Committee, which uses CDC data for its annual reports.
Specifically, perinatal mood and anxiety disorders (depression, anxiety, and affective disorders with psychotic episodes) all greatly impact women’s mental health during pregnancy and up to one year after delivery. The metabolic changes associated with pregnancy may also result in adjusted pharmacological treatment dosage as providers are often hesitant to treat depression or anxiety in pregnant women using antidepressants.
These deaths reflect a myriad of failures in addition to unsafe medical care, including “eroding social support necessary for women to recognize medical warning signs... rapidly accelerated responsibilities, extreme sleep deprivation, and relentless pressure to return to work.”
The transition from pregnancy recover to parenthood is another of “life’s greatest physiological endurance tests,” according to Shah.
A significant responsibility to address the well-being of mothers “lies with the rest of us,” he added. Providers and medical institutions can do more to inform their patients; policymakers can keep track of maternal mortality and associated failures and we as a society need to step up: “birth partners, grandparents, friends, neighbors, professional colleagues — all of us.”
Written by Birthright: A War Story
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