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?
In: 1594
My job is to track the number of kids that die in my state and I have worked here since 1995 so I have a really good handle on what is going on. There are a lot of reasons the numbers are different in the US. First of all we count all infants that even gasp for breath as a live birth, even those that are in no way viable. Human gestation is 40 weeks long, and most countries do not count any births before 22 weeks of gestation as a live birth. Which is sensible since no child under 22 weeks gestation has ever lived long enough to go home and live their life. There are infants as young as 14 weeks gestation being counted as a live birth in the US.
Secondly our medical care is partially at fault. Especially the use of IVF. IVF increases the likelihood of multiples (twins, triplets or more). Which increases the risk of prematurity, high blood pressure, placental abnormalities and other issues. Also advanced maternal age increases the chances of miscarriage or birth defects, thus increasing our infant mortality rate.
Another issue, of course, is poor prenatal care. We all know how expensive medical care is in the US and many women don’t go to the doctor until later in their pregnancy because of the expense. One of the most troubling things is the poor quality of care under Medicaid. You are offered fewer tests that could find issues if you are covered by Medicaid than you get if you are on private insurance. Which means that poor women, the ones who probably need the most help, get substandard care.
TL/DR: we count younger gestational ages, IVF is used a lot and Medicaid sucks
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