U.S. Leads Wealthy Nations in Pregnancy-Related Deaths

By Amy Norton, HealthDay Reporter

WEDNESDAY, Nov. 18, 2020 (HealthDay News) — American women are far more likely to die from pregnancy-related causes than women in other wealthy countries — and a national shortage of maternity care providers bodes ill for the future.

Those are some of the findings from a new report on maternal mortality by the nonprofit Commonwealth Fund, which compared the United States with 10 other high-income nations.

It found what the researchers called “unacceptable” numbers.

In 2018, the U.S. maternal mortality rate stood at 17 for every 100,000 births — more than double the rate of most other countries. Those figures capture deaths during pregnancy and within 42 days of the end of pregnancy.

But many women die later in the so-called “fourth trimester,” or the year after giving birth.

And of all pregnancy-related deaths in the United States, 52% happened after childbirth, the report found. When women died within a week of childbirth, it was often related to severe bleeding, infections or high blood pressure. Later in the postpartum period, the leading cause of death was cardiomyopathy, a weakening of the heart muscle.

“Even though the U.S. spends more on health care than anywhere else in the world, it has higher rates of these preventable deaths,” said report co-author Roosa Tikkanen, a senior research associate at the Commonwealth Fund.

The United States has long held that dubious distinction. And maternal mortality is yet another area where racial disparities are stark: Black women have more than double the death rate of white women in the United States.

The new report adds a layer, Tikkanen said — looking at differences in countries’ health care systems that may illuminate why the United States fares so poorly.

One key difference is the supply of maternal care providers, including obstetricians/gynecologists and midwives.

Nearly all other wealthy nations, except for Canada, have far more providers relative to population. In the United States, there are 15 providers for every 1,000 births, while Sweden has 78 per 1,000, according to the report.