Black Maternal Health Leaves Much to Be Desired in the U.S.

(HealthDay News) — Maternal mortality rates in the United States continue to exceed those in other wealthy nations, with most women dying during pregnancy and childbirth in ways that were preventable, a new report shows.

In 2022, U.S. women had a death rate from complications of pregnancy and childbirth of 22 deaths per 100,000 live births, researchers found.

That’s a rate more than double and sometimes triple that of other high-income countries, researchers said. For example, there were zero recorded maternal deaths in Norway that year.

Further, Black women have the highest maternal death rate in the United States, at nearly 50 deaths per 100,000 live births.

“This study provides a bleak picture of how poorly the U.S. is performing when it comes to maternal mortality rates compared to other high-income countries,” said study author Munira Gunja, a senior researcher with the Commonwealth Fund.

For the study, researchers assessed maternal health across 14 nations: the United States, Australia, Canada, Chile, France, Germany, Japan, Korea, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom.

About two-thirds (65%) of maternal deaths in the United States occur after birth, and more than 80% are preventable, the report found.

Severe bleeding, high blood pressure and infection are the leading causes of maternal death within the first week following delivery, researchers report. In the subsequent weeks and months, weakening of the heart muscle is the most common cause of maternal death.

Compared to other countries, U.S. women are the least likely to have societal supports in place to aid their health, like home visits and guaranteed paid leave.

For example, access to home health visits is guaranteed to women in all countries surveyed except the United States. Other countries guarantee at least one visit by a midwife or nurse within the first 10 days of childbirth, researchers said.

What’s more, all other high-income countries mandate at least 14 weeks of paid leave from work following childbirth, with most mandating more than six months.

The United States also has a severe shortage of maternity care providers, researchers found.

For example, the United States has only 16 midwives per 1,000 live births, and Canada has even fewer, at 13 midwives per 1,000. All other countries have two to six times more, save Korea.

These findings are published June 4 in the Commonwealth Fund report, Insights into the U.S. Maternal Mortality Crisis: An International Comparison.

“The U.S. is still such an outlier, and the racial disparities are profoundly disturbing,” said Dr. Laurie Zephyrin, senior vice president for advancing health equity at the Commonwealth Fund.

“Now is the time to prioritize what we know is already working well in other countries: expanded health insurance coverage, stronger workforce and support systems, and paid maternity leave,” Zephyrin added in a Commonwealth Fund news release.

Why do Black women have the highest maternal mortality rate in the United States?

Black women in the US face a stark disparity in maternal mortality rates, being three times more likely to die from pregnancy-related causes than white women. This isn’t simply a biological issue, but a consequence of a complex web of factors.

One major contributor is unequal access to quality healthcare. Systemic racism and implicit bias can lead to Black women’s concerns being disregarded or downplayed by medical professionals. Additionally, limited access to health care in certain communities, particularly rural areas, creates barriers to proper prenatal care and timely interventions during complications.

Underlying chronic health conditions also play a role. Social determinants of health, like poverty, discrimination, and stress, disproportionately impact Black communities. These factors contribute to higher rates of pre-existing conditions like heart disease and diabetes, which can worsen during pregnancy.

Implicit bias can also manifest in unnecessary medical interventions. Studies suggest Black women are more likely to undergo C-sections, even when medically unnecessary, potentially due to a perception of higher risk.

More information

The American Medical Association has more about maternal mortality in the United States.

SOURCE: Commonwealth Fund, news release, June 4, 2024

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