Where would you rather give birth – in the USA or Albania? Most of you would probably say the USA yet your chances of survival would then be lower. Yes, you as a mother are more likely to die from childbirth-related problems in the USA than Albania. Does that surprise you?
New research looking at maternal mortality is out
Canada and New Zealand have maternal mortality rates that are half of the USA. The UK has one that is a third. Australia’s is a quarter of the USA’s. Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Romania, Kuwait, Lebanon, Iran, and Serbia all have rates that are lower than that of the USA. Countries that American citizens think are lacking in so many areas are proving they are better equipped to care for their mothers than Americans themselves are. Yet I bet you that the majority of Americans are blissfully unaware of this fact. They have to be, because if they aren’t then they are turning a blind eye to a systemic problem that is killing women every day and that is inexcusable.
What’s causing this? It’s not, as some anti-homebirthers would suggest, a rise in homebirth. Although some of the rise may be attributable to how deaths are reported, the lead researcher has stated that even with this rise, the real number is likely larger than what we are seeing now as maternal deaths are often mischaracterized on death certificates. One of the main factors is a rise in certain diseases that make pregnancy riskier, like diabetes and hypertension. There are also other heart and neurological diseases that are on the increase that necessitate higher-risk pregnancies.
If most of these increases are due to increases in diseases, why are other similar, developed countries not showing the same problems? How is all the medical technology in the world failing American mothers? The only thing I can think of is that the system as a whole is broken. At this stage, it’s hard to know what parts actually work, but clearly the system taken together doesn’t. Perhaps it’s the lack of integration, the lack of affordable care, or the focus on treatment instead of prevention. Likely it’s a mix of all of it and more. So what is the USA to do? Are Americans prepared to scrap a system that is failing so many (it’s not just maternal mortality but families being left in debt for regular procedures, people being turned away from treatment because they can’t afford it)? Are people still willing to stand up and say in the realm of health care, the USA is not best? I certainly hope so.
We may not know how to fix the system at the moment, but we do know this: A woman giving birth in China (rank of 57) now has a better chance of survival than a woman giving birth in the USA. Is that really the best the US can offer their mothers?
Oh – to answer the question of where you would be safest giving birth: Iceland with a maternal mortality rate of 2.4/100,000 (nearly 1/8 that of the USA).
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[1] Kassebaum NJ et al. Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet 2014; doi:10.1016/S0140-6736(14)60696-6.
Not to be naysayer, but what about maternal age? We know maternal age within the US has been increasing over this same time period. This is also a systemic problem stemming from both the delay in marriage and the difficulty for many young families to afford a new baby due to the high costs of childcare and the low availability of maternity leave. Maternal age is a huge risk factor.
Except it’s still lower than in Canada and the UK and other countries in Europe. So if it were THAT big of a factor, you’d expect to see the same findings in these countries, but we don’t.
I didn’t realize that. Someone should really run a value-added model of country on maternal and infant survival rates. They could control for factors such as average maternal age, homebirth rate, poverty (or even better income differentials), BMI, diabetes, etc, etc and use value-added to measure the impact that a country’s medical system as a whole has on negative birthing outcomes. Sigh, I need more free time so I can go number hunting.
In nzl we have better rates because we have a midwifery led maternity model which is fully publically funded. We have the same issues with population as the USA. However, if you were to follow the media here you would get the impression that Midwives are responsible for terrible outcomes…. Not true at all,but we all know the media is controlled by those with vested interests
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Where are your source web sites? I saw one.
Anything on infant mortality rates?
(I’ve had 5 homebirths w/very healthy children)
The source is the the reference at the bottom – it’s a medical journal article in the Lancet.
[…] The Lancet illustrates how the surprising disparity in birthing safety applies to mothers, as well. Tracy Cassel summarises The Lancet’s reviewin a recent post at Evolutionary Parenting, where she notes that a mother is […]
Thanks to donor support, Christian Children’s Fund of Canada helps provide a safe place for women to give birth in countries like Ethiopia, Ghana, Burkina Faso, India, Paraguay and Nicaragua.