Kaiser Daily Women’s Health Policy, Pregnancy & Childbirth, Aug 27, 2007
The maternal mortality rate in the U.S. is the highest it has been in decades, according to statistics released this week by CDC’s National Center for Health Statistics, the AP/Washington Post reports. According to the figures, the U.S. maternal mortality rate was 13 deaths per 100,000 live births in 2004. The rate was 12 deaths per 100,000 live births in 2003 — the first year the maternal death rate was more than 10 since 1977 (Stobbe, AP/Washington Post, 8/24). A total of 540 women were reported to have died of maternal causes in 2004, 45 more than were reported in 2003, according to the report (NCHS report, 8/21).
Reasons for Increase
A rise in the number of caesarean sections — which now account for 29% of all births — could be a factor in the increased maternal mortality rate, some experts said. According to a review of maternal deaths in New York, excessive bleeding is one of the primary causes of pregnancy-related death, and women who have undergone several previous c-sections are at particularly high risk of death.
Some studies have found that race and quality of care also factor into the maternal mortality rate. The maternal mortality rate among black women is at least three times higher than among white women. Black women also are more susceptible to hypertension and other complications, and they tend to receive inadequate prenatal care. Three studies have shown that at least 40% of maternal deaths could have been prevented with improved quality of care.
The rise in obesity also might be a factor, some experts said. According to researchers, overweight women tend to have diabetes or experience other complications that could affect pregnancy outcomes. Overweight women also might have excessive tissue or larger infants, which could make a vaginal birth more difficult and lead to more c-sections. More women also are giving birth in their late 30s and 40s, when risks of pregnancy complications are higher, according to the AP/Post (AP/Washington Post, 8/24).
In addition, the report says the increase in maternal deaths “largely reflects” more states’ use of a separate item on the death certificate indicating pregnancy status of the woman. According to the report, the number of maternal deaths does not include all deaths of pregnant women, but only those deaths reported on the death certificate that were assigned to causes related to or aggravated by pregnancy or pregnancy management (NCHS report, 8/21). California, Idaho and Montana in 2003 changed death certificate questions, the AP/Post reports (AP/Washington Post, 8/24).
