Living Ethics Journal

By Beatriz Machado Lacerda.

Having children is supposed to be the miracle of life, but for too many people, it’s a death sentence. Maternal mortality is a significant issue in the US, taking hundreds of lives a year. However, for every other developed country, it is a minor, almost negligible problem. Something in our country is clearly wrong. 

Maternal mortality is defined as the death of a person during pregnancy, childbirth, or within a year of childbirth. The American maternal mortality rate is significantly higher than any other developed country and must be reduced to prevent the loss of thousands of lives and the destruction of families. Here, the maternal mortality rate is about 33 deaths per 100,000 live births, which results in the death of about 1500 women each year (Carroll). There are many factors that can exacerbate this statistic. Black people and Native Americans are about 4 times more likely to die than their white counterparts. Also, people who reside in rural communities are almost twice as likely to die, largely due to a lack of prenatal care (Centers for Disease Control and Prevention). These statistics have worsened over the past few years and will continue to do so, especially in the wake of Roe v. Wade’s overturn. In 2020, maternal death rates were 62% higher in states with restricted abortion access; therefore, as more states ban abortion, more people will die (Declercq et al.).

While all of this may seem daunting, there is still hope. When looking at other developed countries with similar demographics to the US, they have kept their maternal mortality rates low and continued to reduce them over time. However, if the United States were to replicate their results, its approach must consist of three main pillars. The first of which is dismantling racism. Racist systems have led to an increased maternal mortality among minorities, a phenomenon that has not been demonstrated elsewhere. For example, Canada has a similar ethnic diversity to the US, yet their maternal mortality rate is only 7/100,000 live births (Carrol). The next pillar is advancing economic opportunities to increase healthcare access for those who may not otherwise be able to afford it. Unfortunately, we live in a country where medical treatment can be bankrupting, which prevents many people from seeking prenatal care simply because they can not afford it. Their final pillar is increasing access to quality healthcare. Many people in rural areas simply cannot get regular medical attention, something that will not change while pregnant. 

This is common in Finland, where the hospital systems are community based, and are thus much more accessible (Schmidt and Bachmann).  

Such approaches have been successful on a smaller scale for the past few years, but their outreach is limited due to the lack of funding and manpower. Without government initiatives, many of their policies cannot be implemented, such as mandated maternity leave and Medicaid expansion. Dismantling racism, advancing economic opportunities, and increasing access to maternal healthcare are cornerstones of tackling maternal mortality, and as such, it is imperative to take the necessary political initiative to establish an equitable framework for all. 

Works Consulted

“Care during Pregnancy: Family-Centred Maternity and Newborn Care National Guidelines.” Government of Canada, 27 Jan. 2020, http://www.canada.ca/en/public-health/services/publications/healthy-living/maternity-newborn-care-guidelines-chapter-3.html.

Carroll, Aaron E. “Why Is US Maternal Mortality Rising?” JAMA, vol. 318, no. 4, 25 July 2017, https://doi.org/10.1001/jama.2017.8390.

“Pregnancy Mortality Surveillance System .” Centers for Disease Control and Prevention.  23 Mar. 2023, http://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm.

Declercq, Eugene, et al. “The U.S. Maternal Health Divide: The Limited Maternal Health Services and Worse Outcomes of States Proposing New Abortion Restrictions.” Commonwealth Fund, 14 Dec. 2022, https://www.commonwealthfund.org/publications/issue-briefs/2022/dec/us-maternal-health-divide-limited-services-worse-outcomes

Dina Fine, Maron. “Has Maternal Mortality Really Doubled in the U.S.?” Scientific American, 8 Jun. 2015, http://www.scientificamerican.com/article/has-maternal-mortality-really-doubled-in-the-u-s/.

Douthard, Regine A., et al. “U.S. Maternal Mortality within a Global Context: Historical Trends, Current State, and Future Directions.” Journal of Women’s Health, vol. 30, no. 2, 18 Nov. 2020, https://doi.org/10.1089/jwh.2020.8863.

Kargol, Miranda. “Maternal Healthcare Services in Spain.” The Borgen Project, 26 Mar. 2021, borgenproject.org/maternal-healthcare-services/.

MacDorman, Marian F., et al. “Recent Increases in the U.S. Maternal Mortality Rate.” Obstetrics & Gynecology, vol. 128, no. 3, Sept. 2016, https://doi.org/10.1097/aog.0000000000001556.

“Maternal Mortality.” World Health Organization, WHO, 22 Feb. 2023, http://www.who.int/news-room/fact-sheets/detail/maternal-mortality.

“Mom and Baby Action Network.” Mom and Baby Action Network, ignitingimpacttogether.marchofdimes.org/mom-and-baby-action-network.

Schmidt, Alexandra, and Gloria Bachmann. “An Overview of Finnish Maternal Health Care as a Potential Model for Decreasing Maternal Mortality in the United States.” Women’s Health Reports, vol. 2, no. 1, 1 Mar. 2021, https://doi.org/10.1089/whr.2021.0001.