Maternal Mortality: A National Embarrassment

Americans spend more money on childbirth than any other country, but we’re not getting a good return on our investment.

Less than a century ago, approximately one mother died for every 100 live births — an occurrence so common that nearly everyone belonged to a family, or knew of one, that was devastated by such a loss. Fortunately, in most nations, those tragedies have declined over the years. In fact, in the decade between 2003 and 2013, only eight countries saw their maternal mortality rates rise.

Unfortunately, the United States was one of those eight countries, joining a club that also includes Afghanistan and South Sudan. Within the 31 industrialized countries of the Organization for Economic Cooperation and Development, an American woman is more likely to die as a result of pregnancy than a citizen of any other country besides Mexico. Among developed countries, the United States has one of the highest maternal mortality rates — and those rates are only getting worse.

Graph: CDC

U.S. maternal mortality has attracted the attention of organizations whose oversight you wouldn’t expect. Amnesty International, which most Americans associate with the fight against human rights abuses in far-flung authoritarian regimes, considers our high maternal mortality rates to be a violation of human rights. Additionally — and pathetically — one of the biggest sources of funding for maternal health in the United States comes not from taxpayers but from the pharmaceutical company Merck. The Economist quoted a Merck spokesperson as saying, “We expected to be doing all our work in developing countries.” Continue reading

Bearing the Burden of Injustice: Black Maternal Mortality

Mother and babyWhen it comes to maternal mortality, American women don’t all live in the same country. While white women live in Qatar, black women live in Mongolia.

Maternal mortality is death related to complications from pregnancy or childbirth. Most of us don’t come from a time or place where the prospect of dying in childbirth is a tangible possibility — in the past century, as medicine has advanced, maternal mortality rates have plummeted.


To raise healthy families, we need access to general and reproductive health care, including preventive care, prenatal care, and maternity care.


The United States, though, hasn’t come as far as would be expected. Although its wealth should have put it on par with other developed nations like Canada, the United Kingdom, Australia, Japan, and those in Scandinavia, women in these countries fare far better than those in the United States. So do women in Libya, Bosnia and Herzogovina, Bulgaria, and Kazakhstan, indicating that national priorities — and not necessarily national wealth — are key to ensuring maternal health.

The United States’ high maternal mortality rate is heartbreaking no matter how you look at it, but is even worse for women of color. African-American women are 3.5 times more likely to die as a result of pregnancy or childbirth than white women. Between 2011 and 2013, the maternal mortality rate for white women was 12.7 deaths per 100,000 live births. Comparing that to 2015 data from the World Health Organization (WHO), that rate puts white women’s maternal mortality on par with mothers in Qatar and Bahrain, two wealthy Persian Gulf nations. African-American women, however, suffered 43.5 deaths per 100,000 live births, putting their maternal mortality on par with those of Turkmenistan, Brazil, and Mongolia. Continue reading

Book Club: Her Body, Our Laws

By 2014, law professor Michelle Oberman was no stranger to El Salvador. She had already spent four years making research trips to the Central American country, but that June she would need a local guide during her travels. An activist had volunteered to accompany her on the interview she needed to conduct, a task that required a two-and-a-half-hour trip outside the city to an area that is not well mapped — in fact, to a village where there are “no signs or numbers” to help visitors find their way among the cinder-block houses and the patchwork of land where the clucks and lowing of livestock punctuate the silence.


Paid maternity leave, monthly child allowances, and affordable day care and health care decrease demand for abortion.


Once in the village, it took Oberman and her guide an additional 45 minutes to find the house they needed to visit. Inside, a curtain was all that separated the main room from a small bedroom in the back. A bucket and outdoor basin served as a shower, and an outhouse completed the bathroom facilities. The living conditions there were not uncommon — not in a country where roughly 40 percent of the population lives in poverty.

That poverty was both the cause and consequence of a conflict between left-wing rebels and government forces that lasted from 1979 to 1992. In many ways, that conflict set the stage for the abortion war in El Salvador, the subject of Oberman’s recently published book, Her Body, Our Laws: On the Frontlines of the Abortion War from El Salvador to Oklahoma (Beacon Press, 2018).

From Civil War to Abortion War

In the early 1980s, the small republic of El Salvador was in the grip of civil war, while in the U.S., debates raged over the emerging Sanctuary Movement that was aiding Salvadoran and other Central American refugees. The movement began in 1981, when Quaker activist Jim Corbett and Presbyterian Pastor John Fife, both of Tucson, pledged to “protect, defend, and advocate for” the many people fleeing warfare and political turmoil in El Salvador and neighboring countries. Tucson was at the forefront of the movement as refugees crossed through Mexico and arrived at the Arizona border. Continue reading