Save the Children, a non-profit that works internationally to raise money and advocate for children's health and educational opportunities, just came out with it's annual State of the World's Mothers Report. For those of us living in the United States, it looks pretty dismal.
In 2000, 2004, and once again in 2006, the U.S. was listed as one of the top 10 countries in which to be a mother in the world. We've slowly dropped in rank and are listed in the 2014 report at 31st. This rating is mainly a measure of something we in public health call "maternal mortality" which is the polite way of saying "how likely it is that any given woman will die while pregnant."
Seriously. Let's rewind a second and unpack that. In measuring how likely a woman is going to die during the 40weeks of pregnancy or immediately following birth. That could be because of an illegal or otherwise botched abortion. That could be due because she had an unluckily attached placenta that
took over her uterus. That could be due to
high blood pressure or blood clotting, both common in pregnancy. That could be due to infection, sexually transmitted or otherwise. It could be due to her violent partner. Any reason really.
Now that we're out of the Downton Abbey days of medical mystery, people rarely think about death when they see the two little pink lines on that home pregnancy test, but the maternal mortality rate in the U.S. has been
rising. Back in 1990, it was around 12.4 women out of every 100,000 who would die. Today, it's 18.5 per 100,000.
To give you an idea of what those numbers look like, imagine the city of Chicago, which is approximately 2.7 million people. Assume that half are women, so that's 1.35 million people. The difference between a rate of 12.4 and 18.5 is 6.1 extra women dying per 100,000. In Chicago, that 82 women.
82 extra deaths. Now, because math, this does not mean that there were actually 250 maternal deaths in Chicago in 2014 because this is a statistic that looks at risk over life time, but I find that numbers make more sense when they are to scale. Each year, approximately 700 pregnant women die in the United States - seeing as how few women are pregnant at any given time (somewhere
around 2% of women), that's a lot.
So why is this? Why when the U.S. outspends most of the world on health care do we have a maternal mortality rate that rivals Chile's? I have a theory.