What has caused maternal mortality to rise so dramatically in the US since 2000?

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Most poorer countries have seen major drops in maternal mortality since 2000. While wealthy countries are generally seeing a flatlining or slight increasing trend, the rate has nearly doubled in the US. Acutely, (ie the medical issue not social causes) what is causing this to happen? What illnesses are pregnant women now getting more frequently? Why were we able to avoid these in a time (2000) where information sharing and technological capabilities were much worse? Don’t we have a good grasp on the general process of pregnancy and childbirth and the usual issues that emerge?

It seems as if the rise of technology in medicine, increasing volume of research on the matter, and the general treatment level of US hospitals would decrease or at the very least keep the rate the same. How is it that the medical knowledge and treatment regimens have deteriorated to such an extent? Are the complications linked to obesity?

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Anonymous 0 Comments

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Anonymous 0 Comments

The US CDC redefined “maternal mortality” to mean “any death of a woman that occurs either while she is pregnant or within one year of giving birth, regardless of the cause of death, unless the cause of death can be proven to not be the result of the pregnancy.”

The rest of the world redefined “maternal mortality” to mean something that is usually similar to “any death of a woman that occurs during childbirth. Deaths that occur while a woman is pregnant or within a short time of giving birth may be counted if they can be proven to be a direct result of the pregnancy.”

Its very rare for a coroner in the US to prove that a death that otherwise qualified as a “maternal death” was *not* caused by the pregnancy. Conversely, its very rare for health authorities outside of the US to prove that a death that wouldn’t otherwise qualify as a “maternal death” *was* caused by the pregnancy.

The result of this is that the vast majority of maternal deaths in the US come from causes that have nothing to do with pregnancy. There has been a general increase in mortality in the US due to obesity, hence Conversely, the vast majority of true maternal deaths outside of the US typically go uncounted in official statistics.

The US maternal mortality rate has increase modestly since the statistical redefinition. The vast majority of this is due to a surge that occurred in 2021, which itself was the result of inner city violence. Following the George Floyd protests, there has been a tremendous increase in inner city murders.

Many women living in inner city communities are pregnant and/or recent mothers. When they get murdered, their murder is counted in maternal mortality statistics for the above reason. The overall maternal mortality rate in the US is low enough that the surge in inner city murders has had a significant impact on the maternal mortality statistic. Outside of a handful of inner cities, the maternal mortality rate in the US has been more or less flat since the CDC redefined the statistic.

Anonymous 0 Comments

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Anonymous 0 Comments

Gunshot wounds are the leading cause of death for pregnant women in the USA! This is unbelievable. This isn’t Afghanistan or Somalia. It’s a supposed 1st World country! No paid parental leave means women have to use any tiny amount of sick or annual leave they have and then go back to work in a few weeks. This is fucking criminal. Let’s not forget the women having babies they cant afford or just don’t want to have, but do not have access to abortion! 🤬

Anonymous 0 Comments

At least a partial explanation is the increase in obesity among adult women.

In 1995 some 25% of the population in the US were obese or extremely obese. Today that’s approximately 50% of the population, and it’s especially prevalent among low-income women…ie, the people with the worst health insurance.

Obesity and pregnancy is in general a risky combination with a whole slew of issues that makes pregnancy high risk (both directly and indirectly, with comorbidities like diabetes). It also increases the risk for a pre-term delivery and increases both the chance that a cesarean delivery will have to be performed and makes it more difficult to perform.

Also note that the problem with maternal mortality is extremely different between the states. If you just look at the US as a whole the problem is bad, but not looking at it on a state-by-state basis obscures exactly how bad it is. In California maternal mortality is equivalent to some of the best European countries (ie, really good). In Mississippi it’s worse than Mauritius and almost as bad as Guatemala (ie, *much* worse than it should be).

Anonymous 0 Comments

This thread is ripe with wrong, partially true, and tons of unsourced non-factual pundit information. Buyer beware.

Anonymous 0 Comments

“(ie the medical issue not social causes)”

It’s literally due to the social causes. You can’t politicize peoples bodily autonomy and create laws regulating what medical care that group can and cannot have access to due to their bodies containing and organ that gestates new life without severe repercussions. The sexism prevalent in medicine and the ongoing history of medical racism are direct causes of substandard medical care that leads to maternal and infant mortality. Our medicine is amazing and top notch. There’s no medical reason we should have increasing maternal mortality, at all.

Anonymous 0 Comments

The complete and utter absence of a healthcare system?

Anonymous 0 Comments

Sexism and easy access to guns are big factors.

“Homicide during pregnancy or within 42 days of the end of pregnancy exceeded all the leading causes of maternal mortality by more than twofold.”

https://pubmed.ncbi.nlm.nih.gov/34619735/

Anonymous 0 Comments

One factor is the downstream effect of a high c-section rate – placental problems. Each c-section increases the risk of placenta issues in the NEXT pregnancy including the risk of placenta acretta where the placenta grows THROUGH the uterus and can even attach onto other organs. This is extremely dangerous.

Maternal age also increases some maternal morbidity and mortality risks, and due to economic reasons many are putting off pregnancy until later.

Finally, hospitals are staffed so that women are rushed through, and nurses have more patients than they really should care for at one time. We have some of the most advanced training in the world, but if you have too many patients that doesn’t really matter.