Pregnancy-Related Deaths in the US

[Daniel E.]

Maternal Mortality in the United States: A Primer

A decades-long focus on improving hospital maternity care may have diminished the importance of community-based care and overlooked racial/ethnic disparities.

www.commonwealthfund.org

DECEMBER 16, 2020

In 2017, at a time when maternal mortality was declining worldwide, the World Health Organization (WHO) reported that the U.S. was one of only two countries (along with the Dominican Republic) to report a significant increase in its maternal mortality ratio (the proportion of pregnancies that result in death of the mother) since 2000. While U.S. maternal deaths have leveled in recent years, the ratio is still higher than in comparable countries, and significant racial disparities remain...

The most recent U.S. maternal mortality ratio, or rate, of 17.4 per 100,000 pregnancies represented approximately 660 maternal deaths in 2018. This ranks last overall among industrialized countries...

More than half of recorded maternal deaths occur after the day of birth...

Even higher education does not protect Black mothers from pregnancy-related death...

The causes of maternal death vary considerably and depend on when mothers die. These data are based on a report from maternal mortality review committees...

During pregnancy, hemorrhage and cardiovascular conditions are the leading causes of death. At birth and shortly after, infection is the leading cause. In the postpartum period, often during the time when new parents are out of the hospital and beyond the traditional six- or eight-week post-pregnancy visit, cardiomyopathy (weakened heart muscle) and mental health conditions (including substance use and suicide) are identified as leading causes...

 

[Daniel E.]

About Pregnancy-Related Deaths in the United States

Most pregnancy-related deaths are preventable.

www.cdc.gov

Most pregnancy-related deaths are preventable.

Although deaths related to pregnancy are rare, about 700 women still die each year in the United States from complications due to pregnancy. In addition, there are considerable racial disparities. American Indian, Alaska Native, and Black women are two to three times more likely to die of pregnancy-related causes than white women. This is unacceptable.

Almost two thirds of pregnancy-related deaths are preventable. Recognizing the urgent maternal warning signs, getting an accurate and timely diagnosis, and quality care can save lives.

 

[David Baxter PhD]

^^ Absolutely agree. The reversal of Roe vs Wade is unacceptable, punitive, and discriminatory.

 

[Daniel E.]

As always:

 

[Daniel E.]

Social Programs Weak in Many States With Tough Abortion Laws
By Associated Press
April 7, 2022

States with some of the nation’s strictest abortion laws are also some of the hardest places to have and raise a healthy child, especially for the poor....

Mississippi has the nation's largest share of children living in poverty and babies with low birth weights, according to 2019 data from the U.S. Census Bureau and the Centers for Disease Control, the latest available. Texas has the highest rate of women receiving no prenatal care during their first trimester and ranks second worst for the proportion of children in poverty who are uninsured...

Maleeha Aziz, an organizer for the Texas Equal Access Fund, had an abortion when she was 20 after birth control failed. She was a recent immigrant from Pakistan and a college student sharing a one-bedroom apartment who knew she couldn’t afford to raise a child financially.

Her broader experience also reflected the health risks inherent in many pregnancies. She had a condition called hyperemesis gravidarum, which causes persistent, extreme nausea and vomiting.

“I was a vegetable. I could not move,” said Aziz, who later had a daughter. “Pregnancy is not a joke. It is the hardest thing that a person’s body will ever go through.”

 

[Daniel E.]

Traumatic pregnancies are awful. Dobbs will make that so much worse.
The Washington Post
June 24, 2022

Some pregnancies and births are difficult enough to give mothers PTSD. When a pregnancy is unwanted, the physical and psychological strains will be even more severe.

...And hyperemesis gravidarum is far from the worst physical ailments that pregnant women can face. Other afflictions include life-threatening diseases such as preeclampsia, which affects an estimated 5 to 7 percent of pregnant women, or pulmonary embolisms.

People who give birth willingly can, with difficulty, reconcile themselves to pregnancy-related trauma because they desperately want to have a child. But if I had not desired my daughter with all my heart, the physical pain I experienced, which also caused psychologically scarring, would have been akin to torture...

 

[Daniel E.]

Americans seeking abortion get help from Mexico

Facing high medical costs and pressure to reconsider, a single mother living in California turned to activists across the border in Mexico who helped her have an abortion.

www.france24.com

June 25, 2022

In contrast to the US ruling, Mexico's Supreme Court last year declared the laws criminalizing abortion unconstitutional, authorizing it de facto throughout the conservative Latin American country.

In Mexico City, which decriminalized abortion in 2007 and provides free care regardless of place of residence, authorities pledged to support women from the United States following the court ruling.

"It's truly regressive, sad and outrageous that in a country where these rights had been recognized they are going backwards. We'll be ready to help," the city's health secretary, Oliva Lopez Arellano, told AFP.

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The Mexico City Model of Abortion Care (Published 2022)

Why the city may be a blueprint for progressive American states.

www.nytimes.com

May 23, 2022

...Dr. López Arellano knows it is unlikely American women will take her up on the offer en masse. In the United States, more than half of all abortions are now administered with medication. In Mexico City, the share is even higher: Medication abortions now make up the majority of abortion services provided by public clinics. The increasing accessibility of medication abortion has given rise to safely self-administered abortions, a shift that the pandemic accelerated. As a result, it is now often cheaper and more efficient for women to source those pills within the United States or just across the border, instead of traveling to Mexico City.

Still, she believes Mexico City could become a model for American states looking to provide comprehensive health care to both women within their state and those who may need to travel regionally for abortion care — as many women are forced to do in Mexico.

 

[Daniel E.]

I Had Postpartum PTSD but It Went Undiagnosed

Postpartum PTSD can be caused by birth trauma. Here are the symptoms and why it's often undiagnosed.

www.parents.com

March 23, 2022

Inequity in Maternal Health Care Left Me With Undiagnosed Postpartum PTSD

The condition—often caused by birth trauma—impacts up to 17 percent of birthing people, but it's often underdiagnosed and undertreated, especially among lower-income patients.

...My husband was in graduate school and we had just moved to a new city. I was juggling three low-paying jobs with no benefits, which placed me on Medi-Cal, California's Medicaid health care program, through a clinic east of Los Angeles. The payout for Medi-Cal patients is lower, so doctors who take it slot these appointments back-to-back to compensate. The first OB-GYN I saw said, "You shouldn't care how you're treated. You don't work. You aren't paying." I told her I had been paying government taxes since I started working at 16 years old, and still was. I walked out of her office and never looked back.

It's no wonder my symptoms went undiagnosed. Poverty is a leading factor in maternal vulnerability in the U.S., according to 2021 data released by Surgo Ventures. Beyond the physical impact of health care disparity for birthing people, maternal depression rates are an estimated 40 to 60 percent higher for low-income people, according to the Georgetown University Health Policy Institute. As a white woman who did not grow up in poverty, I have much more privilege than some. There is staggering racial disparity in maternal health care: Black, American Indian, and Alaska Native women are two to three times more likely to die from pregnancy-related causes than white women, according to the Centers for Disease Control and Prevention. When birthing people of color live in low-income communities, the inequities increase even more....

The OB-GYN whom I ultimately stayed with never got to know me. He sped through each appointment; I barely got a question in. When he told me he wouldn't be in the delivery room, I shouldn't have been caught off guard, but I still was...

 

[Daniel E.]

$40 to hold your own baby at a US hospital:

 

[Daniel E.]

Barbara Ehrenreich - Wikipedia

en.wikipedia.org

In 1970, Ehrenreich gave birth to her daughter Rosa in a public clinic in New York. "I was the only white patient at the clinic, and I found out this was the health care women got," she told The Globe and Mail newspaper in 1987, "They induced my labor because it was late in the evening and the doctor wanted to go home. I was enraged. The experience made me a feminist."