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More American moms die in childbirth than in other wealthy nations

Posted August 16

The CDC says that America leads the way in an unhappy statistic among developed nations: More of its women die in childbirth than in similarly wealthy countries — and the numbers are going up. Experts think they know why. (Deseret Photo)

The Centers for Disease Control and Prevention says that America leads the way in an unhappy statistic among developed nations: More of its women die in childbirth than in similarly wealthy countries — and the numbers have been rising in recent years.

The experts think they know why, and it's a challenge that's been brewing for a long time.

"Thirty years ago, almost a third of all pregnancy-related deaths were because of hemorrhages — or women bleeding to death," reports Vox. "But today that number has dropped by nearly a third. Hemorrhages now account for 11.4 percent of pregnancy-related deaths. Deaths related to embolisms and pregnancy-related hypertension disorders have also steadily declined. And deaths due to anesthesia complications have almost entirely disappeared."

Instead, American women in this century are dying during child birth of pregnancy complications related to chronic conditions like heart disease and diabetes. And one of the factors that health officials and others point to is an increase in obesity, as well.

Writes Sarah Frostenson for Vox, "Pregnancy-related deaths are still rare events in the (United States); only about 700 women die out of 4 million live births annually. But the U.S. is one of the few rich countries in the world where maternal mortality is steadily rising. The maternal mortality rate has more than doubled since 1987, the first year the (CDC) began collecting data through its pregnancy mortality surveillance system."

It's not a new concern, but that childbirth-related deaths continue to rise has increased the alarm. A year ago, The Economist noted that "by 2013 the rate had ticked up to 18.5 women for every 100,000 births (these numbers include women who die within 42 days of childbirth). This makes America an international outlier. Between 2003 and 2013, it was one of only eight countries, including Afghanistan and South Sudan, to see its maternal-death rate move in the wrong direction. American women are now more than three times as likely to die from pregnancy-related complications as their counterparts in Britain, the Czech Republic, Germany or Japan."

Health officials have pondered a variety of factors that may contribute to the rising rate, starting with the possibility American health care providers are, perhaps, simply better at keeping count than in the past. It has also been suggested that an increase in the average age at which women give birth has been rising in America, as the Deseret News reported, could influence the risk, with older moms more risky medically than younger ones. Or perhaps, it's been suggested, the increase in C-sections — nearly one-third of babies are now delivered that way — confers the increased complication rate.

But as The Economist explains, "the most compelling explanation is that more American women are in poorer health when they become pregnant, and are failing to get proper care. Chronic health conditions, such as obesity, hypertension, diabetes and heart disease, are increasingly common among pregnant women, and they make delivery more dangerous. Indeed, the traditional causes of pregnancy-related deaths, such as hemorrhage, thromboembolism and hypertensive disorders, have been declining in recent years, whereas fatalities from cardiovascular conditions and other chronic problems have been on the rise."

The CDC notes that preventing pregnancy-related death and injury is a task that starts well before childbirth and even before pregnancy. "It is important for all women of reproductive age to adopt healthy lifestyles (e.g., maintain a healthy diet and weight, be physically active, quit all substance use for good, prevent injuries) and address any health problems before getting pregnant. Visit your health care provider at recommended scheduled time periods to discuss if or when you are thinking about getting pregnant. This is important to make sure you receive appropriate medical advice and care, and have healthy pregnancies.

"A healthy pregnancy begins before conception and continues with prenatal care, with early recognition and management of complications if they arise. Health care providers can help women prepare for pregnancy and for any potential problems during pregnancy. Early initiation of prenatal care by pregnant women, and continuous monitoring of pregnancy by health providers, are key to preventing pregnancy-related complications and death," CDC said.

Email: lois@deseretnews.com, Twitter: Loisco

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