3,613,647 babies were born in the United States in 2020, a number that increased to 3,659,289 in 2021 (the latest year of available statistics). This was the first increase in the number of infants born since 2014. But sadly In 2021, there were 1,205 maternal deaths giving a maternal death rate of 32,9/100,000 births. While in 2021 the Covid Pandemic was still a major health concern; many doctors think that this death rate is not just due to covid but is due to worsening heart health and the increased obesity among the population. It is difficult to obtain the exact cause of maternal death as there are coding problems of deaths of pregnancy and postpartum individuals due to suicide, homicide, and drug overdose. These deaths are not always recorded in ways that link to a pregnancy. Therefore, maternal deaths are under reported.
How have these death rates impacted the economy? Or put another way, what is the economic burden of maternal deaths to US society? Dr. Robert S. White from Weill Cornell Medical School in New York studied this question. He reports that during the time period 2018 to 2020 whites accounted for 57% of births, Hispanics accounted for 25% while black among blacks made up 16%. Within these groups Hispanics had higher fertility and birth rates. In this time frame maternal deaths increased. There were 658 maternal deaths in 2018, 754 deaths in 2019 and 861 maternal deaths in 2020. Looking at datasets available to the public (CDC Wide-ranging Online Data for Epidemiology Research Data Base) (US Social Security Actuarial Life Table) White and his colleagues calculated Years of Potential Life Lost (YPLL) and the Value of Statistical Life (VSL) to determine the economic burden. Both the YPLL and VSL are standard calculations used by economists in economic cost-benefit analysis. VSL represents the accepted amount of funds that would be needed to prevent an outcome, in this case, maternal mortality. They do not factor in the costs of medical care, funeral expenses and other costs related to the deaths which would be borne by the relatives of the deceased. Therefore, not all costs are captured in this analysis. White and his team also looked at subsets of the maternal deaths by age and calculated these costs. Their published findings are important and sobering.
In 2018 the economic burden or cost to society was $7,899,886,448.00 (Rounded to $8 billion). The 2019 cost was $9,145,319,766.00 (Rounded to $9 billion). In 2020 the cost was a staggering $27,426,000,000.00 (Rounded to $27 billion). When a cost is put on maternal deaths, it should focus our attention and make all of us demand that our elected leaders engage and debate appropriate measures to prevent maternal mortality. Meaningful bills need to be passed to fund health care programs that will address this serious problem. Interestingly, White and his team showed that the cost percentages by race for maternal death was not identical to the percentage of births by race. White maternal morality accounted for 47% of economic measures, 35% of blacks and 18% of Hispanics, indicating racial disparities in maternal deaths. Many news articles have reported the heath disparities of maternal mortality. White and his colleagues demonstrate the disparities in the economic burden.
When the data was categorized by age during this three-year period the researchers found that 321 individuals under 25 years died compared to 1609 of those 25-39. Three hundred forty-two individuals aged 40 and over died. Fifteen percent of the maternal deaths were to persons over 40. Others have documented that maternal deaths in older individuals are due to obstetrical hemorrhage, postpartum cardiomyopathy, obstetric embolism, preeclampsia/eclampsia, and complications of surgery and obstetrical procedures.
In their discussion the researchers point out that variations in hospital care factors are associated with maternal mortality. Variations in the knowledge base of the care givers is a factor as well.
When economic factors are considered, the incredible cost we in the US pay for not having a health care system that prevents maternal mortality shows with great clarity that we have failed in our approach to maternal and child health and all childbearing families. In order to call attention to this failure. The Campion Fund is planning a scientific meeting for October 2024 to discuss solutions to eliminating the US high maternal mortality rate. We will be co-sponsoring this meeting with Frontier Nursing University in Kentucky, a university dedicated to promoting nurse-midwifery, family nurse practitioners, psych-mental health practitioners and is a leader in promoting healthy maternity and family care.
Reference:
White RS, Lui B, Bryant-Huppert J, Chaturvedi R, Hoyler M, Aaronson J. Economic burden of maternal mortality in the USA, 2018-2020. J Comp Eff Res. 2022 Sep;11(13):927-933. doi: 10.2217/cer-2022-0056. Epub 2022 Jul 14. PMID: 35833509.