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

Let’s Talk Contraception: Birth Control Pills — Not Just for Preventing Pregnancy

pillThere has been a lot of political posturing recently about whether the government should require health insurance to provide birth control without a co-pay as part of a preventive health care package. So many people, including politicians, can only “see” the contraceptive side, which is pretty important, by the way. Approximately 15.8 in 100,000 women in the United States die from pregnancy or pregnancy-related issues yearly, and that number has doubled in the past 25 years. We have one of the worst maternal death rates of all developed nations, right near the bottom of the list.


Birth control pills can be used to treat a variety of conditions, including painful periods, acne, endometriosis, and uterine fibroids.


But putting all that aside, let’s look at the how oral contraceptives pills (OCPs) are actually used in this country, and for what reasons besides contraception. You may argue that many birth control pills are only approved for contraception purposes by the Food and Drug Administration (FDA), so other uses are not valid. But many drugs that may have narrow conditions of approved use are often prescribed off-label by physicians when they have data and information about how effective they can be for other conditions where not much else works.

According to a 2011 study using data from the 2006–2008 National Survey for Family Growth, the Guttmacher Institute reported that 14 percent of all women using birth control pills — that’s 1.5 million women — use them for purposes other than preventing pregnancy. Granted, 86 percent of OCP users report using them for birth control. But over the years, these OCPs have helped many people as treatments for dysmenorrhea, menorrhagia, endometriosis, menstrual-related migraines, acne, uterine fibroids, and polycystic ovarian syndrome. Continue reading