Two items to consider:
- The US is the “leader” among developed countries in the percent of new mothers who die in or immediately following childbirth.(1) In fact, the death rate in the US is higher than some developing countries, notably Iran, Libya and Turkey.(4)
- The primary cause of deaths among new mothers in the US is heart failure.(2)
- The World Health Organization has found that half of the deaths in the US were preventable.(4)
The reported death rate of new months has risen by 27% over the last four years, and has doubled in Texas. Alone among the 50 states, California has achieved a reduction in deaths.
Some of the stated causes for this increase:
- Better reporting (although the author of the study finding the 27% increase says that is a true increase, not due to government record changes).
- Inconsistent access to quality health case, such as the closing of clinics in Texas.
- Racial disparities in healthcare.
- Overuse of C-sections.
- Pregnancy among older women.
The New York Times ran a story this weekend which illustrates the problems of access to healthcare. Black women are four times as likely to have medical complications in pregnancy as white women in America.
As her January due date grew closer, Landrum noticed that her hands, her feet and even her face were swollen, and she had to quit her job because she felt so ill. But her doctor, whom several friends had recommended and who accepted Medicaid, brushed aside her complaints. He recommended Tylenol for the headaches. “I am not a person who likes to take medicine, but I was always popping Tylenol,” Landrum says. “When I told him my head still hurt, he said to take more.”(5)
Headaches and swelling of hands and feet are symptoms of preclampsia, which is diagnosed through blood pressure measurement and urinalysis (checking for protein in the urine). The disease requires attention: preclampsia can lead to liver and kidney damage, seiures (eclampsia), and can be fatal. Simply prescribing Tylenol is not adequate treatment.(7)
The author of the Times article ascribes the problems facing black mothers to racial prejudice. However, a review in Medscape points out that mortality rates are similarly high for Hispanics and Native Americans.(6)
My suspicion is that the issue comes back to money. Logically, better doctors are going to gravitate toward where they can get better pay, and that’s in upscale suburban hospitals and clinics. The US is highly segregated economically. People in poorer and rural settings have access to fewer physicians and those physicians are unlikely to be top quality professionals. Native Americans who are dependent on Federal medical service have the same issues that veterans have with the VA.
The rich is places like New York City, Philadelphia, Boston, Chicago, and Los Angeles have access to a quality of healthcare that the rest of the country doesn’t realize its missing.
Politicians who are using the abortion debate as an excuse to reduce spending on healthcare are in fact killing people.
In any case, the bottom line is that the US is now a relatively dangerous place to give birth.
- Mulubrhan F. Mogos, Mariann R. Piano, Barbara L. McFarlin, Jason L. Salemi, Kylea L. Liese, Joan E. Briller. Heart Failure in Pregnant Women. Circulation: Heart Failure, 2018; 11 (1): e004005 DOI: 10.1161/CIRCHEARTFAILURE.117.004005
- University of Illinois at Chicago. “Women most at risk for heart failure weeks after giving birth.” ScienceDaily. ScienceDaily, 10 April 2018. <www.sciencedaily.com/releases/2018/04/180410084221.htm>