February 05, 2024

Maternal Mortality: Understanding the Issues

Recently I was searching on line for current articles discussing US maternal mortality rates which I do from time to time. I stumbled across a commentary stating as fact that because the US reports maternal deaths by a different definition of maternal death than other nations the comparison of our high rates with other developed countries are not accurate. The case that countries collect health statistics differently and perhaps not as accurately as the US is true. But I was surprised to note that the author of these comments calculated US maternal mortality rates using other countries criteria to demonstrate that our rates compared to other countries, particularly developed European and Asia nations are lower than what is currently reported by our National Center for Health Statistics. The implication was that the US is not so bad as newspapers and TV reports would have us believe. This implication is very misleading for even when calculated in this manner our rates are still high relative to other countries’ rates. The author did state at the end of the paper that the aim was to merely show the differences in rate determination and not to negate the hard fact that the US has extremely high maternal mortality.  I am not sure that this statement eliminates an erroneous interpretation, namely that because the collection and calculation methods differ from country to county the US rates are not so high and thus, somehow, we should not be overly concerned. The paper I stumbled across does an injustice to all those working to promote safer childbirth experiences for Americans facing childbirth. The conclusion of the paper in my opinion does not help us in our approach to maternal health.  It is in the wider context of things a distraction from the real problem of death during pregnancy, birth and the postpartum year of life. Death is death and is a tragedy for society when it occurs in a young person. In any sophisticated and scientifically advanced nation, no one should die as a result of pregnancy.

So what comparison is important? Let’s compare the US maternal mortality of our current time with that of the US from the 197os and 1980s. Here are the stats. In 1976 the overall rate was 21.5/100,000 live births. By 1980 this had dropped to 9.2/100,000 with further drop to 7.2 in 1987.  Contrast this with the current rates of 32.9/100,000 and the 20.1/100,000 in 1919.  These rates clearly indicate that we have a serous health problem to be overcome. We were able to lower the rates once in our history and we certainly can do so again.

When I was a student in the 1960’s my professors of public health discussed vital statistics as a measure of the overall health and welfare of a population. Maternal mortality was considered by these teachers to be a Gold Standard Marker of health of a nation. The lower the better.  

All those working in maternal health as well as all our citizens have work to do. To help with critical decisions in implementing programs to alleviate our extremely high death rate the Campion Fund is partnering with the Frontier Nursing University to organize and hold meeting highlighting local and regional research evidence-based programs that have demonstrated ways to avoid maternal death that actually work. Many of these programs have been in place for a number of years. We hope that by reporting on successful programs that encompass multiple and coordinated strategies we can show our national leaders proven ways to reduce needless maternal deaths. The meeting will be held September 19, 2024 at the Frontier Nursing University Campus in Versailles, Kentucky. and will be both in person and virtual. We encourage attendance as well as the submission of abstracts outlining programs currently active that demonstrate evidence that they work to reduce maternal mortality.  Registration will be available next month on both the Campion Fund and Frontier Nursing University’s websites.