Save the mothers
The well-known international aid group Save the Children offered up an unusual Mother’s Day present this year. Instead of buying flowers, it issued a warning that American mothers—and fathers and sisters and brothers—should take to heart. In its annual release, “State of the World’s Mothers,” Save the Children reports that among countries with advanced economies, the United States is the worst place to be a mother.
The United States ranks 61st globally in maternal health, far behind its economic peers. According to researchers, a woman in the United States is 10 times more likely to die from a pregnancy-related cause than a woman in Austria, Belarus, or Poland. In top-ranking Norway, a woman has a lifetime risk of 1 in nearly 15,000 of dying in childbirth. In the United States, the chances are 1 in 1,800. In fact, the likelihood of maternal death in the United States places the world’s greatest industrial and military power among many of the poorest developing countries.
Save the Children’s research corroborates findings published in The Lancet last year. Researchers there found that in 2013 maternal mortality in the United States was more than double the rate in Saudi Arabia and Canada and triple the rate in the United Kingdom.
Millennium Development Goal (MDG) 5, established by the United Nations in 2000, calls for a 75 percent reduction in the number of maternal deaths by 2015. Latin America and Asia have remained on a path toward the successful completion of MDG 5. The task has proved hardest in West and Central Africa, regions plagued by some of the worst poverty and conflict in the world.
But superpower America is also heading backward. At 18.5 maternal deaths for every 100,000 births, the maternal death rate in 2013 was more than twice 1987’s rate of 7.2 deaths per 100,000.
Between 2003 and 2013 only eight countries had increases in maternal mortality. The United States was the only major industrialized power among this unfortunate subset, joining nations like Afghanistan, Belize, El Salvador, and the Republic of South Sudan. Debt-driven economic disorder, gross poverty, civil war, terrorism, and drug trafficking are part of the national profiles of seven of these eight poor performers on MDG 5. How to account for the United States’ poor outcome?
Researchers are still pondering that question. They point to some possible suspects, including greater maternal age and higher rates of obesity, diabetes, and other chronic illnesses. But breaking out economic data about life in the United States offers other clues. While many affluent zip codes maintain maternal mortality rates comparable to high-income states in Europe, in the nation’s poorest communities the rates skyrocket to developing world levels. Could the nation’s flagging commitment to social services and increasing wealth inequity have something to do with its embarrassing showing on maternal health?
Among the abysmal statistics unearthed by Save the Children is this regrettable finding: Among capital cities in high-income countries in 2013, Washington had the highest infant mortality rate at 6.6 deaths per 1,000 live births—“three times the rates found in Tokyo and Stockholm.” Save the Children attributes that outcome to social inequities that are simply not found in other advanced economies.
“There are . . . huge gaps between rich and poor in Washington,” they write. “Babies in Ward 8, where over half of all children live in poverty, are about 10 times as likely as babies in Ward 3, the richest part of the city, to die before their first birthday.”
Poor maternal outcomes are a social wound caused by our country’s own policies. The political will to respond—through improved education, better community-based pre- and post-natal health services, and family-friendly workplace policies—is the only obstacle to remedying this inexplicable, inexcusable American health crisis.
This column appeared in the August 2015 issue of U.S. Catholic (Vol. 80, No. 8, page 39).
Tuesday, August 11, 2015