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Amnesty International Condemns U.S. For Soaring Maternal Death Rates

by on Friday, March 12, 2010 at 4:00 pm EDT in Healthcare, Politics

In a scathing new report released today, Amnesty International calls on U.S. President Barack Obama to address its spiraling maternal mortality rates and soaring pregnancy related complications (which disproportionately affects minorities and those living in poverty):

More than two women die every day in the USA from complications of pregnancy and childbirth. Approximately half of these deaths could be prevented if maternal health care were available, accessible and of good quality for all women in the USA.

Maternal mortality ratios have increased from 6.6 deaths per 100,000 live births in 1987 to 13.3 deaths per 100,000 live births in 2006. […]

The USA spends more than any other country on health care, and more on maternal health than any other type of hospital care. Despite this, women in the USA have a higher risk of dying of pregnancy-related complications than those in 40 other countries, [including nearly all the industrialized countries]. For example, the likelihood of a woman dying in childbirth in the USA is five times greater than in Greece, four times greater than in Germany, and three times greater than in Spain. […]

A total of 1.7 million women a year, one-third of all pregnant women in the United States, suffer from pregnancy-related complications.

The report also revealed that severe pregnancy-related complications that nearly cause death — known as “near misses” — are rising at an alarming rate, increasing by 25 percent since 1998.

US Amnesty executive director Larry Cox weighs in:

“This country’s extraordinary record of medical advancement makes its haphazard approach to maternal care all the more scandalous and disgraceful. Good maternal care should not be considered a luxury available only to those who can access the best hospitals and the best doctors. Women should not die in the richest country on earth from preventable complications and emergencies.” […]

“Mothers die not because the United States can’t provide good care, but because it lacks the political will to make sure good care is available to all women.” […]

The group blasts the U.S. health care system as one that systematically creates barriers to keep pregnant women from getting coverage:

The way in which the health care system is organized and financed fails to ensure that all women have access to affordable, timely and adequate maternal health care. For many women, health care costs are beyond reach.

Half of all births are covered by private insurance. However, policies that exclude maternal care are not uncommon and most insurance companies will not provide coverage for a pregnant woman unless she had insurance before she became pregnant.

Some 42 percent of births are covered by Medicaid, the government-funded program for some people on low incomes. However, complicated bureaucratic requirements mean that eligible women often face significant delays in receiving prenatal care.  […]

Women who do not receive prenatal care are three to four times more likely to die of pregnancy-related complications than women who do. Those with high risk pregnancies are 5.3 times more likely to die if they do not receive prenatal care.

The group pointed out many other systematic failures, including:

  • Nearly 13 million women of reproductive age (15 to 44), or one in five, have no health insurance. Minorities account for just under one-third of all women in the US A (32 percent) but over half (51 percent) of uninsured women.
  • One in four women do not receive adequate prenatal care, starting in the first trimester. The number rises to about one in three for African American and Native American women.
  • A shortage of health care professionals is a serious obstacle to timely and adequate care, especially in rural areas and inner cities. In 2008, 64 million people were living in “shortage areas” for primary care (which includes maternal care).
  • Many women are not given a say in decisions about their care and the risks of interventions such as inducing labor or cesarean sections. Cesarean sections make up nearly one-third of all deliveries in the US A – twice as high as recommended by the World Health Organization.
  • The number of maternal deaths is significantly understated because of a lack of effective data collection in the USA.

Here’s a bird’s eye view of how countries rank on lifetime risk of death from pregnancy related causes (as reported by the World Health Organization:

1. Ireland 1 in 47,600

2. Bosnia and Herzegovina 1 in 29,000

3. Italy 1 in 26,000

4. Greece 1 in 25,900

5. Austria 1 in 21,500

6. Germany 1 in 19,200

7. Czech Republic 1 in 18,100

8. Denmark 1 in 17,800

9. Sweden 1 in 17,400

10. Spain 1 in 16,400

26. United Kingdom 1 in 8,200

41. United States 1 in 4,800

In its new report, Amnesty disclosed maternal mortality ratios (per 100,000 live births) for each of the 50 states, and the nation’s capitol:

51 — Washington, DC (34.9 deaths per 100,000 live births)
50 — Georgia (20.5)
49 — New Mexico (16.9)
48 — Maryland (16.5)
47 — New York (16.0)
46 — Louisiana (15.9)
45 — Mississippi (15.2)
44 — Arkansas (14.6)
42 — Delaware, Michigan (13.6)
41 — Florida (13.1)
40 — Nebraska (12.6)
39 — Oklahoma (12.3)
38 — Tennessee (11.7)
37 — North Carolina (11.4)
35 — New Jersey, California (11.3)
34 — W. Virginia (11.2)
32 — South Carolina, Idaho (11.1)
31 — Colorado (11.0)
30 — North Dakota (10.7)
28 — Missouri, Montana (10.5)
26 — Nevada, New Hampshire (10.4)
25 — Alabama (9.6)
24 — Rhode Island (9.2)
23 — Illinois (9.1)
22 — Kentucky (8.8)
20 — Texas, Utah (8.6)
19 — Pennsylvania (8.5)
18 — Ohio (8.4)
17 — Virginia (8.0)
16 — Wyoming (7.8)
15 — Washington (7.5)
13 — Arizona, Wisconsin (7.2)
12 — Iowa (7.0)
10 — Oregon, South Dakota (6.2)
9 — Kansas (5.9)
8 — Connecticut (5.1)
7 — Alaska (5.0)
6 — Hawaii (4.7)
5 — Minnesota (3.7)
4 — Indiana (3.3)
3 — Massachusetts (2.7)
2 — Vermont (2.6)
1 — Maine (1.2)

To put this in perspective, a pregnant woman in our nation’s capitol is fifteen times more likely to die from childbirth than a pregnant woman in Greece, twelve times more likely to die than a pregnant woman in Germany, and nine times more likely to die than her counterpart in Spain.  And yet, ironically many of our politicians who live and work in that very same city, continue to tout U.S. health care as the “best in the world.”


Generate an instant email (c/o Amnesty International) to Kathleen Sebelius @ the US Department of Heath and Human Services demanding immediate action.