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Compared with other
wealthy countries, the US is the most dangerous place to give birth by a
wide margin. There were 23.8 deaths for every 100,000 live births in
2020, up from 20.1 in 2019, according to the latest statistics from the Centers for Disease Control and Prevention. By contrast, data
from the Organization for Economic Cooperation and Development
suggests that in France — the next most-risky industrialized nation for
childbirth — the figure is just 7.8. Research suggests
these numbers are due to a mixture of factors. For one, the absence
of universal health care means that Americans can face high
out-of-pocket costs — leading many to skip the doctor. The US also has
the fewest maternal health providers and midwives of any high-income
country.
Racial inequities also play a role. Pregnancy-related
mortality rates for Native American and Black women are two and
three times higher than the US average, respectively. And in rural
areas, where access to maternity care is often limited, women are about 60% more likely to die before, during or after birth. The
federal government is taking steps to address this longstanding
problem. This time last year, Vice President Kamala Harris convened the
first-ever federal Maternal Health Day of Action
at the White House, where she issued a call for federal agencies,
businesses and nonprofits to work together to solve the maternal health
crisis. I heard
about the resulting initiatives during a Department of Health and Human
Services event in Washington earlier this month. Chiquita Brooks-LaSure,
the head of the Centers for Medicare & Medicaid Services, said
there that most states expanded Medicaid postpartum coverage from 60
days to 1 year, with help from the American Rescue Plan Act of 2021. She
also unveiled a birthing-friendly hospital designation — essentially a
badge awarded to hospitals that have demonstrated a commitment
to maternity care quality, safety and equity. More than 25 healthcare plans have agreed to display the icon in their hospital directories. But despite the federal push, attention to this issue at the state level still varies. For example, 15 Republican-led states haven’t expanded Medicaid postpartum coverage. Some states are already seeing results. New Jersey launched a campaign called Nurture NJ that
aims to reduce the state’s maternal mortality rate by 50% over five
years. The state was also the first in the country to have community
doulas reimbursed by Medicaid. It is one of only four states that
have reduced preterm births, according to a recent report by nonprofit March of Dimes. From 2016 to 2021, the preterm birth rate fell from 9.9% to 9.2%. New
Jersey’s First Lady, Tammy Murphy, has been fighting to tackle the
maternal mortality crisis in the state since her husband came into
office five years ago.
”We have a long way to go,” she said. “But
it gives us a little bit of a kick in our step and now we can at least
point to something.” — Fiona Rutherford |