Reproductive Health

Pieces of a U.S. Maternal Health Plan Take Shape

Tuesday, June 7, 2011

A bill in Congress would help states research why so many U.S. women die in pregnancy and childbirth. And that data could make health reform more responsive to a worsening problem, a leading health activist says.

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Report Spurs Briefing

Amnesty International USA, which regards maternal care as a basic human right, spurred the recent briefing on the bill, held by Rep. John Conyers, D-Mich. Strauss says Amnesty International's interest in the issue began with its global Demand Dignity campaign to end human rights abuses linked to poverty.

"As part of that we have taken up specific issues, including maternal mortality, in countries like Sierra Leone, Burkina Faso, Indonesia, Peru and others," Strauss says. "But, as with all issues, Amnesty International feels strongly that human rights are not a framework that applies only to other countries but one that we need to use to look at issues confronting us in our own back yard."

Strauss adds that they began by looking at global data from the U.N. on maternal mortality and it quickly became very clear "which wealthy country is falling behind in that area. The U.S. spends the most on maternal care of any country, with results that don't match that investment."

The United States is tied with Saudi Arabia in maternal mortality, according to the U.N. data, with both sharing the rank of having the 50th highest maternal mortality rates globally, meaning 49 other countries have better statistics.

The pregnancy-related maternal mortality rate, the report found, in the United States was 24 per 100,000 live births from 1990 through 2008. Greece had the best outcomes, at two deaths per 100,000 live births; Afghanistan was worst, with an estimated 1,400 women dying per 100,000 live births.

Daily Maternal Deaths

The high U.S. rate means two to three women die of pregnancy-related causes every day in the country and 34,000 women suffer life-threatening complications each year during pregnancy or childbirth.

The Amnesty report notes that people who live in middle-income areas in the U.S. have a 58 percent higher risk of pregnancy-related death than those in high-income areas.

It also finds that that the majority of maternal deaths are preventable, from causes such as hemorrhage, pulmonary embolism, pre-eclampsia and eclampsia, which can be related to lack of pre-natal care or lack of quality care.

Other deaths, making up the minority, result from complications that are not considered preventable, like amniotic fluid embolism or aneurism.

"States that have higher than the national average C-section rate, which is now 33 percent, have a 21 percent higher risk of maternal mortality," Strauss says.

The Maternal Accountability Act has 41 co-sponsors so far, including one Republican, freshman Congressman Andy Harris of Maryland, who's a physician.

Survivors of women who have died from pregnancy-related causes spoke at the briefing alongside congressional staffers, physicians and community activists.

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Melinda Tuhus is an independent journalist based in New Haven, Conn.

For more information:

The Maternal Health Accountability Act:
http://www.opencongress.org/bill/112-h894/show

Amnesty International USA:
http://www.amnestyusa.org/

"Deadly Delivery: The Maternal Health Care Crisis in the USA" report:
http://www.amnestyusa.org/research/reports/deadly-delivery-the-maternal-health-care-crisis-in-the-usa

Black Women's Health Imperative:
http://www.blackwomenshealth.org/

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