Many people associate pregnancy with joy, especially if the person pregnant wanted to have a baby. Cultural norms usually drive us toward thinking about pregnancy and childbirth as a joyous occasion to be celebrated.
While this is true, it is also the case that a shadow hangs over pregnancy and childbirth in the U.S. in the form of our surprisingly high rate of maternal mortality.
NERD ALERT! The World Health Organization (WHO) defines a maternal death as “the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes.” In other words, a maternal death is a death that arises from the pregnancy and can also happen up to 42 days after a pregnancy is terminated if the cause is related to the pregnancy or the delivery/termination of the pregnancy.
In the most recent data from 2020, the maternal death rate in the U.S. was 23.8 deaths per 100,000 live births. Causes of death include blood clots in the lung, high blood pressure, and blood loss. This rate has only increased in recent years. To give you a sense of how unusually high that is for a high-income country like the U.S., that rate is 1.8 in Norway and, at the high end, 6.5 in the United Kingdom. The second highest maternal mortality rate in an industrialized country is 8.7 in France, which is still almost 3 times lower than the rate in the U.S.
The situation is even worse for non-White people living in the U.S. In 2020, the maternal mortality rate for non-Hispanic Black women was 55.3, almost 3 times as high as the rate for non-Hispanic white women, which was 19.1. All of these numbers have been steadily increasing in recent years.
So…now we get it that maternal mortality is very high in the U.S. But why? Why is this happening?
This is a very difficult question to answer. This deserves a post of its own, but some of the most important contributing factors: poor access to healthcare/lack of insurance coverage for large swaths of the population; high levels of underlying illnesses that can make pregnancy more dangerous, including obesity, diabetes, and heart disease; and, importantly, systemic racism, discrimination, and health disparities. This last factor is a clearly a huge contributing factor as the current maternal mortality rate is about 3 times higher in Black versus non-Hispanic white women. These are by no means all of the reasons – just a quick glance. There are undoubtedly more things we don’t know or aren’t even thinking about.
So should fear accompany every positive pregnancy test? Of course not. Overall, rates of death in pregnancy or immediately thereafter are still low in an absolute sense. Most pregnant people will do fine. However, it is true that the vast majority of the deaths we do see are preventable, and that means that our health system is not doing what it should to protect people.
If you are pregnant or were recently pregnant and think you have a health issue, talk to your doctor immediately. All pregnant people should have some basic knowledge about the signs of preventable health complications. We will share that in another post!
For now, stay well, stay healthy.
Those Nerdy Girls