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U.S. Is “Most Dangerous” Place in Developed World to Give Birth

by Countable | 7.26.18

The story

The U.S. is the “most dangerous place to give birth in the developed world,” according to a USA Today investigation.

Every year in the U.S., more than 50,000 mothers are severely injured during or after childbirth and 700 die.

USA Today’s investigation found that women are dying and suffering life-altering injuries during childbirth because hospitals aren't following well-established safety measures.

Context

The USA Today investigation, along with various other independent studies, shows that the maternal death rate in the U.S. has been rising steadily, and that the U.S. now has the highest rate in the developed world.

California presents a notable exception. According to the USA Today investigation, hospitals and safety advocates there have instituted practices that have cut the state’s maternal death rate in half.

Possible cause

The USA Today investigation posits one explanatory factor:

“[R]egulators and oversight groups that could require hospitals to do more have not...
“The lack of action by the Centers for Medicare and Medicaid Services to protect mothers stands in sharp contrast to its more aggressive approach to trying to improve care for elderly Medicare patients.
“As a condition of getting Medicare payments, the federal agency requires hospitals to disclose information such as complication rates for hip and knee surgeries and whether heart attack patients got prompt care. All of that information is posted online.
“That same agency helps pay for about half of the nation’s nearly 4 million births each year via Medicaid, and it could set similar rules about childbirth complications.”

Disparity

The most notable disparity in mortality rates in the U.S. is defined by race: Black women die at a rate that ranges from three to four times the rate of their white counterparts — 42 deaths per 100,000 live births among black women versus 12 deaths per 100,000 live births among white women as of 2010.

American Indian and Alaskan Native women also fare worse than white women with approximately twice as many pregnancy-related deaths per 100,000 live births. 

Further reading

USA Today’s full investigation includes a state-by-state ranking of maternal harms and deaths as well as a guide with tips for how patients can advocate for themselves during childbirth.

What do you think?

Should regulators strengthen their disclosure requirements of hospitals in order to get Medicare payments? Are other regulatory remedies in order? Why or why not? Hit Take Action to tell your reps what you think, then share your thoughts below.

—Sara E. Murphy

(Photo Credit: iStock.com / laflor)

Countable

Written by Countable

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(77)
  • burrkitty
    07/27/2018
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    Hmmm...Every other place in this study has free universal healthcare. Fascinating.

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  • I.Got.an.Idea...
    07/27/2018
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    This is not new. The U.S. has held this statistic for at least a few decades. When you seek profits over a person’s health and life safety, this is the result. We need to look at Root Cause to provide real solutions. Making more money at the expense of a person’s life, is not a solution. For those that believe that National Health Care in other countries is worse, look at empirical data. You would be proved incorrect, again.

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  • Andy1
    07/27/2018
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    We are run by an anti-science, anti-fact, anti-moral, anti-human political party. This should surprise exactly no one. AND FUCK ALL OF YOU THAT SAY YOU SHOULDN’T HAVE TO PAY FOR BETTER. You pay either way - let’s finally do what the rest of the world has already figured out

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  • burrkitty
    07/27/2018
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    Oh, and for the science-denialists out there, here’s a short reading list to help start alleviating your willful ignorance: Health care disparity and state-specific pregnancy-related mortality in the United States, 2005-2014 Obstetrics & Gynecology | October 2016 Deadly delivery: The maternal health care crisis in the USA & 2011 update Amnesty International | 2010 & 2011 Pregnancy-related mortality in the United States, 2006-2010 Obstetrics & Gynecology | January 2015 Reproductive injustice: Racial and gender discrimination in U.S. health care Center for Reproductive Rights, Sister Song, National Latina Institute for Reproductive Health | 2014 Racial/ethnic disparities in obstetric outcomes and care: Prevalence and determinants American Journal of Obstetrics & Gynecology | April 2010 Black-white differences in severe maternal morbidity and site of care American Journal of Obstetrics & Gynecology | January 2016 Shifting the frame: A report on diversity and inclusion in the American College of Nurse-Midwives ACNM | June 2015 Racial disparities in comorbidity and severe maternal morbidity/mortality in the United States: an analysis of temporal trends Acta Obstetrica et Gynecologica Scandinavica | October 2017 Recent Publications Association between maternal adherence to healthy lifestyle practices and risk of obesity in offspring: results from two prospective cohort studies of mother-child pairs in the United States BMJ | July 2018 Hypertensive disorders of pregnancy and maternal cardiovascular disease risk factor development: An observational cohort study Annals of Internal Medicine | July 2018 Birth outcomes of women using a midwife versus women using a physician for prenatal care Journal of Midwifery & Women's Health | June 2018 Barriers and pathways to providing long‐acting reversible contraceptives in Massachusetts community health centers: A qualitative exploration Perspectives on Sexual and Reproductive Health | June 2018 A conceptual framework for the impact of obesity on risk of cesarean delivery AJOG | June 2018

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  • IllWill
    07/27/2018
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    For anyone who says that we need to get back to a free market or private healthcare system, FYI, the U.S. healthcare system is already dominated by private companies particularly private health insurance. Obamacare didn’t wreck this system. Private healthcare companies are going to do whatever lines their pockets which does not mean they’re going to be focused on getting patients the best care. The only real solution to this problem is a Medicare-for-all system that focuses on getting good medical care for everyone in all medical procedures including giving birth.

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  • jeremiahjmeadows
    07/27/2018
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    It seems like California is doing well, so let’s see what they’re doing differently—as well as other developed countries with lower rates. Then, let’s allow regulators to impose regulations that encourage lower rates.

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  • Wesley
    07/27/2018
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    Simple, ask other nations what The heck they do to get less rates, then, copy as needed.

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  • Christine
    07/27/2018
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    This is insane! Please look into why women are NOT heard, cared for or cared about regarding the risks of giving birth which includes in the days and weeks after. This is grossly misogynistic.

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  • TrulyTexan
    07/27/2018
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    If only there were an organization that could help prevent this. Maybe we could start one. It could be called Planned Parenthood and they could provide affordable, safe, science based healthcare to women. Or the republicans could just keep thinking of women as disposable breeding stock. Decide which is better and vote accordingly in November and beyond.

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  • David
    07/27/2018
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    According to the article, 60% of the deaths are those with hypertension. It doesn’t look like many hospitals have treatment protocols to deal with the obesity epidemic among young people in the U.S. Hospitals have geriatric protocols for dealing with the elderly and pediatic protocols for dealing with children, toddlers, and infants but when you become an adult it’s one size fit all until you are classified as elderly. Sad that so many young adults do not take more responsibility for that part of the problem.

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  • Nick-Papagiorgio
    07/27/2018
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    Lest we forget. Merika is also the most dangerous place in the developed world to: seek political asylum, go to school, drive a car, be arrested, be black, or to be a woman.

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  • David
    07/27/2018
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    This just proves that a third party payer system doesn’t work. In this case the Gov’t spends someone else’s money to buy something for someone else. There is no concern for cost or quality in this third party payer system. Return it to a free market system where quality and cost are determined directly by the buyer.

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  • operaman
    07/27/2018
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    Must be factoring in abortions. The facts are in the data and data can be manipulated.

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  • Clara
    07/27/2018
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    It’s cus we don’t listen to women’s pain/issues, we give birthing patients c sections and episistomies when they don’t need it just cus the docs want them to give birth on THE DOCTOR’S time, and because doctors and nurses screw up by not following safety measures but then try to blame it on someone else. The amount of black/native women who die during childbirth is even higher too. These aren’t freak accidents, most of these are preventable but the doctors and nurses are trying to say it’s not. These deaths are also more likely to occur to women who are poor. Look over at what other developed nations are doing and do what they do with evidence based birth and you know ACTUALLY caring about the mother’s health and checking up on her thoroughly, not just money. Also free health care

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  • Dicr
    07/27/2018
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    We can only hope that republicans don’t maintain control and candidates who care about constituents replace them and do something. We’ve made business great enough.

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  • Laura
    07/27/2018
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    We have become a third world country because of the GOPs war on women, progress and equality. Vote them out! Vote blue!

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  • ManfromNebraska
    07/27/2018
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    Our sue happy society raises costs and money that could be used for improvements is wasted. Obamacare would make things worse as resources are strained. We need to invest more in our medical services and research. Some Hospitals seem overwhelmed. As a nation we aren’t that healthy due to our indulgences. Individually we need to do better about what we do, and how we eat.

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  • Sandra
    07/27/2018
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    Our democracy is one of the few that do NOT have National Health Care...now, this administration wants to do away with the facilities that provide care for pregnant women and provide birth control....the fact that 700 women die per year while giving birth in "The Greatest Country in the World" is unconscienable. (sp?)...Again, I ask the question, how can an administration declare themselves to be "Pro Life" and gut the ACA, gut Medicare, Medicaid, SNAP, CHIPS, Meals on Wheels and threaten Soc. Sec....this administration is NOT "Pro Life" apparently....A more correct description would be "Pro Fetus"

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  • Robert
    07/27/2018
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    Find out what California has been doing. Then make it mandatory for all states to replicate its procedures in order to receive Medicaid funding. States rights be damned when it involves people’s lives. Then adopt Medicare for all so that our nation’s healthcare becomes affordable and of the highest quality.

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  • Courtney
    07/27/2018
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    This is exactly what happens when you put profit over people.

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